Member Service Representative

1 day ago


Leawood, Kansas, United States Advantage Tech Full time
Member Service Representative

At Advantage Tech, we're seeking a highly motivated and detail-oriented Member Service Representative to join our team. As a key member of our operations team, you will play a critical role in ensuring our members receive exceptional support and service.

Key Responsibilities:
  • Member Support: Provide compassionate and dedicated support to ensure the member experience is in line with company values.
  • Benefits Education: Educate and assist members on various elements of benefit plan information, including claim status and benefits.
  • Claims Triage: Triages claims and escalate issues as appropriate through the system for grievances and appeals.
  • Provider Support: Assist members in finding accepting providers and facilities that address their needs, and coordinate with Member Advocate for issues related to provider access escalations.
  • Documentation: Accurately document, research, and resolve all inquiries by ensuring documentation is clear and complete.
  • Quality Standards: Meet or exceed individual and departmental quality standards / achieves performance goals.
Requirements:
  • Education: Bachelor's degree or equivalent job experience.
  • Experience: Minimum 2 years prior experience with health plans, benefit plans, claims, and/or healthcare required. Minimum 2 years of experience in member service in a healthcare environment.
  • Skills: Strong member service skills, excellent written and verbal communication skills, strong inter-personal and problem-solving skills, convey compassion and be detail oriented.


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