Member Relations Representative
1 month ago
The Member Relations Representative is responsible for acting as a liaison between members, health plans, and physicians. Individuals are required to perform at minimum 120 outbound attempts per day to Medi-Medi, Medicare, Commercial, POS and Medi-Cal members who are existing members with enrollment errors or are identified as potential terminations and other services necessary to ensure member healthcare satisfaction, wellness, and retention is accomplished.
Complete all outbound retention effort campaigns as assigned Complete all inbound retention calls. Track outcome of all retention efforts Assist with member inbound calls as needed. 100% thorough documentation of every call. Thoroughly verify HIPAA requirements to ensure account accuracy. Follow-up on all open issues. Communicate recurring issues and trends to management. All other duties as assigned.Minimum Education: Bachelor’s Degree preferred. High School Diploma or equivalent required.
Minimum Experience: A minimum of two years of customer service experience in a call center environment required. A minimum of two (2) to three (3) years of IPA/HMO experience. Ability to project excellent customer service, negotiation, and conflict resolution skills via telephone in a fast-pace environment while maintaining a professional demeanor. Bi-lingual preferred. Advanced working knowledge in Microsoft Programs (PowerPoint, Word and Excel). Ability to multi-task, prioritize, and work in a fast pace environment. Knowledge of IPA/HMO. Proficiency in Microsoft Office Excel and Outlook applications.
Req. Certification/Licensure: None.
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