Job Description
Job Title: Member Services Specialist
Location: Irving, Texas, 75038
Shift: 9am to 5pm, Monday to Friday
Schedule: 5 days a week - 40 hours
Roles and Responsibilities:
- 2 years of customer service experience in healthcare, insurance, and call center environment.
- Must have excellent understanding of benefits, products, & other health care and/or insurance issues as they pertain to our customers (internal/external).
- Facilitates member & provider understand of the plan coverage and benefits by thoroughly researching inquiries in an efficient and professional manner
- Records all contact with customers, both verbal & written in the current MIS system
- Required to assist in training/re-training new and current employees
- Maintains accurate documentation of all telephone contact, walk-in customers, any mail inquiries by documenting to ensure a clear audit trail for reporting purposes
- Responsible for handling all incoming calls and the making of outgoing calls as needed in order to resolve any issues or questions
- Triage phone request to other areas such as Utilization Management and Provider Relations
- Handles incoming written correspondence in a timely and professional manner