Healthcare Member Services

Posting ID : A1068468075
Date Posted : 2015-08-18
Category : Healthcare

1.Healthcare Dental Customer Service
Do you have experience in the dental or healthcare field? Immediate opening for a member services representative to provide excellent customer service by answering phone inquiries from members and providers regarding dental benefits, eligibility, and all other related inquiries. Requirements include the ability to work in a fast paced environment answering up to 80 calls per day and provide quality customer service through one-call resolution. As a member service representative you will be responsible to develop and maintain positive customer relations and coordinate with various departments within the company to respond to customer requests in a prompt and professional manner. This position requires excellent verbal and written communication skills and the ability to complete multiple tasks and navigates multiple systems while on the telephone to respond thoroughly to a caller's inquiries. If you love to talk with people of the phone and have 1 year of previous dental experience in a dental office, with insurance or with another dental group this may be the position for you.
Irvine Location $14.00 to $15.00 per hour

2.Member Services
Would you like to work for a company in Orange that has a 30-year history of successfully supporting its members and management? Are you a recent college grad with a healthcare degree? We have an immediate openings for a company located in the central Orange County area for a Member Service Representative to assist with open enrollment for Medicare Advantage. Responsibilities include answering customer service calls from members, providers, pharmacy, service representatives and staff members, explaining the plans benefits, procedures, services for customer service calls including providers and employers requesting benefits, eligibility, authorization for outpatient surgery or claims concerns for members, referral requests to other providers who are part of network, hospital admission and pre-admit authorization requests, members with eligibility problems, COBRA, claims & other concerns regarding their coverage, pharmacies with eligibility problems, drug authorization and drug co-pays and researching of any RX claims issues. Respond to incoming correspondence as it relates to claims and file as needed and maintain member satisfaction and retention via rapport building and proper identification of member, employer, provider, and service representative needs The right candidate will have 2-4 years of previous experience working in a call center or healthcare call center customer service environment. Must possess basic analytical and problem solving skills, have good written and verbal communications skills, and have strong organization and prioritization skills.
Orange Location $14.00-$15.00 per hour

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