Member Service Rep

1 month ago

Sacramento, United States LHH Recruitment Solutions Full time
Job DescriptionJob Description

The Member Services Representative (MSR) is responsible for being the primary point of contact for members and providers who interact with internal departments or external entities, including Medical Groups, Health Care Providers, and Brokers. 

Responsibilities

  • Accurately record and refer appeals and grievances according to department protocols and procedures.

  • Educate members on the Referral Program, the company website, and the self-service tools available online.

  • Assist members, providers, brokers, and plan partners with claims-related billing questions and issues as needed.

  • Work with inter and intra-department staff to help resolve member issues to ensure resolution within prescribed timeframes.

  • Manage difficult or emotional customer situations, respond promptly to customer needs, solicit customer feedback to improve service, respond to service requests, and meet commitments.


Qualifications

  • High School Diploma.

  • A minimum of 2 years of experience working in a call center in a healthcare setting.

  • A minimum of 1 year of previous experience working in the healthcare industry, specifically HMOs.

  • Basic computer skills, including electronic mail, routine databases, word processing, spreadsheet, graphics, etc.

  • Bilingual is a plus



Pay Details: $18.00 to $21.00 per hour

Search managed by: Joanna Calderon

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
  • The California Fair Chance Act
  • Los Angeles City Fair Chance Ordinance
  • Los Angeles County Fair Chance Ordinance for Employers
  • San Francisco Fair Chance Ordinance

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