Member Services Representative Ii - Pearland, United States - KS Management Services, LLC

KS Management Services, LLC

Verified Company

Pearland, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Responsibilities

Job Title:
Member Services Representative II -KSPA

Location:
Pearland Administrative Office

Department:
Mem Provd Serv**
Job Type: Full Time

Salary Range:
$49,730 - $61,442 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)

Qualifications

Education

Required:
High School diploma or GED from an accredited program

Preferred:
Associates or bachelor's Degree

Experience

Required: 5 years' experience in a health care or health plan insurance environment.

Benefits, Medical Benefit Interpretation, CMS Regulations, Texas Department of Insurance Regulations and

ERISA
Excellent interpersonal skills to interface with physicians and members of the health plan.

Strong ability to actively listen to customers, probe for clarification, and provide consultative guidance based

upon customers inquiries.

Excellent written communication skills

Analytical skills to evaluate problems and recommend alternative solutions

Preferred:
Previous experience with a call documentation system

Knowledge of Medical Terminology

Ability to Work in a Fast Paced Continuously Changing Environment

Knowledge of CPT and ICD9 Codes

Ability to understand complex oral and written directions and technical information.

License(s)

Required:
N/A

Preferred:
N/A

Special Skills

Required:
Strong knowledge of HMOPOS and TPA Plan Design and Claims Processing

Member Service Representatives must build and maintain productive

Preferred:
EPIC" Tapestry Experience

Other

Required:
Excellent communication and telephone etiquette

Problem-Solving and active listening skills

Representative III are required to pass knowledge testing and maintain positive Quality and Production Scores

Preferred:
Fluency in Spanish

Working Environment:
Office

About Us
Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston's fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties.

Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner.

Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.

Why Kelsey-Seybold Clinic?