Member Services Representative
7 days ago
Solis Health Plans is a Medicare Advantage Company that provides innovative solutions to improve the healthcare experience for its members and providers. Our mission is to deliver high-quality, personalized service that exceeds expectations.
Job SummaryWe are seeking a highly skilled Member Services Representative to join our team. This individual will be responsible for providing exceptional customer service to our members, addressing their inquiries, and resolving issues in a timely and professional manner.
Key Responsibilities- Handle customer inquiries via phone, email, and in-person, providing accurate and timely responses to ensure member satisfaction.
- Assist members with coverage decisions, grievances, appeals, benefit interpretation, eligibility verification, and other related matters.
- Maintain accurate records of customer interactions and resolve issues in accordance with company policies and procedures.
- Collaborate with internal teams to resolve complex issues and provide exceptional customer service.
- Stay up-to-date on company policies, procedures, and regulatory requirements to ensure compliance.
- Participate in ongoing training and development to enhance skills and knowledge.
- High school diploma or equivalent required; 1 year of healthcare experience preferred.
- Working knowledge of HIPAA regulations and ability to maintain confidentiality.
- Excellent communication, interpersonal, and problem-solving skills.
- Proficient in Microsoft Office and ability to learn new software systems.
- Ability to work in a fast-paced environment and prioritize tasks effectively.
- Fluency in English and Creole required.
Solis Health Plans offers a comprehensive benefits package, including medical, dental, and vision coverage, as well as a 401(k) plan with a 100% company match. We are committed to providing a supportive and inclusive work environment that fosters growth and development.
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