Description:* We are actively seeking to hire a Member Services Advocate to serve members by being an advocate and point of contact for member questions and concerns regarding benefits, eligibility, referrals, claims and any other aspects of plan benefits and services. Must be able to ensure member satisfaction by providing superior customer service and a willingness to help at all times while maintaining a professional demeanor.
Follow up with members by clarifying the customer’s issue, determine the cause, and identify and explain solutions. Escalate appropriate member issues to management or other departments as required.
Consistently meets and/or exceeds the departmental standards, including, but not limited to: quality, productivity, and adherence to schedule and attendance.
Respond appropriately and in a timely fashion to members/internal staff/ and providers by answering telephonic and written inquiries concerning benefits, eligibility, referrals, claims and all other issues while following departmental policies and procedures and job aids. Follow up on issues, focusing on providing solutions and options for member, as necessary through resolution of member issue.
Increases member satisfaction by following up and resolving member issues, complaints, and questions in an efficient, timely and accurate fashion; coordinates resolution with providers and other departments as needed.
Follow all appropriate Federal and State regulatory requirements and guidelines applicable
Documents transactions by completing applicable member forms and summarizing actions taken in appropriate computer system and following standards set by the department or by other authorized individuals.
Top Skills Details:* Member Services, Call Center, Customer Service
Additional Skills & Qualifications:* MUST HAVE: High School diploma or equivalent required.
1 - 2 years call center or related customer service experience Computer Savvy skills
Ability to work in a quiet place
Hours during training: 8-4:30 PM (Mon-Fri) After training: must be open between the hours of 6 AM - 8 PM (Mon-Sun) - must be available to work weekends + any shift
Experience Level:* Entry Level Please contact me for more details!