Member Services Representative addresses member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for receiving, responding to, and directing member phone calls, or written questions. Being a Member Services Representative provides available information upon request and researches or escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines. Additionally, Member Services Representative requires a high school diploma or equivalent. Typically reports to a supervisor or manager. The Member Services Representative works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Member Services Representative typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
Member Service Representatives wear countless hats. As the gatekeeper of the dental offices, their hospitable and engaging personalities open the door for patients and keep them returning with their family and friends for life. We’re looking for someone who can make an impressive first impression and who can build ongoing rapport with each and every patient. Are you an enthusiastic, collaborative extrovert with supreme communication skills? If so, we say, come join our team!
Duties & Responsibilities:
- Follow opening and closing dental front office procedures.
- Greet visitors, handle incoming calls on a multi-line system, and perform general clerical tasks.
- Support group members, CCO partners, Staff and Panel offices
- Coordinate front and back office patient flow through communication with the doctors and other staff members.
- Assist patients in the completion all necessary paperwork, set up accounts and make charts for each new patient.
- Manage office’s daily schedule, make appointments and edits as necessary.
- Perform other administrative duties as assigned.
Location:
Qualifications:
- Previous Call Center experience
- Bilingual preferred
- Must have excellent verbal and written communication skills
- Computer literate a must
- High school diploma or GED required
Benefits Include:
Compensation