Senior Member Service Representative

3 weeks ago


San Antonio, Texas, United States University Health System- San Antonio Full time

Position Summary: As a Senior Member Service Representative at University Health System-San Antonio, you will serve as a liaison to members and providers regarding benefits and services, resolving member and provider issues, and providing information regarding all aspects of the Special Health Care Needs (SHCN) call center.

Key Responsibilities:

  • Ensure compliance with HIPAA-related policies, including Abuse, Neglect and Exploitation (ANE), and Fraud, Waste, and Abuse (FWA).
  • Provide comprehensive knowledge of STAR Kids and STAR+PLUS programs to members and providers.
  • Staff designated at primary to STAR Kids' hot-line must answer 95% of STAR Kids calls.

Requirements:

  • Minimum two (2) years of college-level work in business, health care administration, or related courses.
  • Four (4) years' experience as a customer service representative.
  • Minimum of two years of HMO experience.


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