Member Services Rep II - Team1Medical
Pearland, TX 77584
About the Job
Member Services Representative II
Salary Rate: $27.00/hr.
Location: Pearland, TX
Shift: Monday – Friday 8:00am - 5:00 p.m.
Employment Type: Temporary
We are looking for a Member Services Representative II to join a clinical team with a multi-specialty clinic. You will assisting members calling inquiring about health plan policies and complete surveys. Whether it be now or later, you do not want to miss this opportunity. Submit your resume today to see what possibilities are available
What you will be doing:
- Provide Concierge Service to members of the health plan which include providing a high level of service to callers and making outreach calls to members to provide information regarding health plan policies, obtain responses to various required surveys and promote member retention and growth initiatives.
- Resolve inquiries from health plan members, providers, and various customers while consistently exceeding productivity, quality and service standards.
- Proven ability to quickly learn and put into practice software applications to respond to administrative issues related to health plan operations including claims resolution, premium billing, medical benefit interpretation, organization and coverage determinations, referral inquiries, Prescription Drug inquiries and enrollment/disenrollment activities.
- Handles member and provider calls for our Medicare Advantage plan and have demonstrated ability to interpret Medicare Policy and Procedures including but not limited to Late enrollment penalty, low income subsidy, enrollment/disenrollment guidance, Medicare beneficiary protections and Medicare coverage rules.
- Support chat conversations and make outbound calls to assist with scheduling member appointments and to determine disenrollment reasons
What is Required:
- Five (5) years of experience working in a healthcare insurance environment.
- Knowledge of HMOPOS and TPA Plan Design and Claims Processing.
- Ability to interpret/apply Medicare Prescription Drug Benefits and Medical Benefits Interpretation.
- High School diploma or GED is required.
- Must pass knowledge testing and maintain positive quality and production scores.
Benefits and Perks:
- Work Schedule: Monday – Friday, 8:00 a.m. – 5:00 p.m., with no weekends to offer a good work/life balance.
- During employment with Team1Medical Staffing, you can enroll in our benefits program, including medical (3 plans to choose from), dental, disability, critical illness, life, vision, accident, and behavioral health insurance. Additional benefits include 401K, direct deposit, and our referral bonus program!
Your Career Partner:
Team1Medical, a The Reserves Network company, is a veteran-founded and family-owned company, specializes in connecting exceptional talent with rewarding opportunities. With extensive industry experience, we are dedicated to helping you achieve your professional goals and shine in your field.
The Reserves Network values diversity and encourages applicants from all backgrounds to apply. As an equal-opportunity employer, we foster an environment of respect, integrity, and trust in every aspect of employment.
Source : Team1Medical