Member Service Representative Level 1 - West Covina, United States - BeneSys, Inc.
Description
Member Service Representative Level 1 (West Covina, CA)
Summary - This is a call center environment. Call center experience is required. **The Member Service Representative responds to incoming telephone calls from client participants and providers with questions about Health & Welfare benefits. This is a Union position.
Essential Duties and Responsibilities include but not limited to
- Positively respond to incoming calls from members and providers by, among other things:
- explaining group benefits
- providing information on referrals
- describing required authorizations for medical care
- assisting with claims' issues
- providing claims' status
- answering questions or concerns
- resolving problems
- Submit requests for adjustments on claims, research questions and problems, and provide the best solutions available.
- Alternate with coworkers during slow periods to make sure phones are always covered.
- Make outgoing calls to members and providers.
- Alpha sorting, organizing, or other special projects.
- File forms and letters.
- Provide available information upon request and escalate issues as appropriate to Supervisor and/or Manager.
- Retain records of calls by documenting in the appropriate system for tracking.
- Other duties may be assigned.
- Reliable and predictable attendance is an essential function of this job.
Member Services Representative Levels
- Level I
- Some customer service experience, some claims knowledge, good phone skills, positive attitude, medical knowledge a plus.
- Level II
- Level I
- Level III
- Level I
Supervisory Responsibilities No supervisory responsibilities
Qualifications
- Background in medical claims processing.
- Call center experience.
- Knowledge of and capable of handling multiple group benefits.
- Ability to communicate clearly with accurate information to callers either by telephone, electronic messaging, or facetoface interaction.
- Ability to deal with people in stressful situations.
- Ability to use good communication skills and keen observation to understand what a caller is asking for and then use good judgment to come to a resolution.
- Ability to multitask, respond to questions correctly and accurately and resolve the issue from initial contact with caller.
- Ability to diffuse irate calls to a level where the caller is satisfied with the response and resolution is complete.
- Ability to work well in a team environment and independently.
- Good working knowledge of Microsoft Excel/Word.
- Regular and predictable attendance is an essential function of this job.
Education and/or Experience - High School diploma or GED equivalent. 2 plus years in an Employee Benefits position or similar.
Language Skills - Effective communication skills are essential. Individual should enjoy and be able to work in a busy and sometimes noisy/high pressured environment.
Physical Demands - Occasional lifting of paperwork and batches of claims.
Regular use of standard office equipment such as:
computers, phones, photocopiers, fax machines, etc. Sustained periods of being on the telephone, keyboarding, sitting/standing.
Work Environment - The position operates in a typical call center environment, that, at times, can be noisy, pressured and stressful. The department can be fast paced.
Work Schedule - Full time. Monday - Friday, 8:00am - 5:00pm. Required in office (no at-home days).
Competitive Benefits
- Medical/Dental/Vision, with option for dependent coverage
- Flexible spending accounts
- Companypaid basic life/AD&D, shortterm disability, longterm disability insurance
- 15 days Paid Time Off during first full calendar year
- 11 paid holidays
- Up to 5 days of paid bereavement leave
- Up to 20 days of paid jury duty leave
- 401(k) with employer match
Pay
The current starting rate for this position is $32.16. This is a union position. The wage rate for this position is determined by the collective bargaining agreement and may be dependent on experience, skills, education and other
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