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Member Services Representative (Medicare)

FULLY FLEXIBLE
Remote: 
Full Remote
Contract: 
Experience: 
Entry-level / graduate
Work from: 
Minnesota (USA), United States

Offer summary

Qualifications:

High school diploma or GED required, 2 year degree in health related or liberal arts preferred, Knowledge of company products and services.

Key responsabilities:

  • Resolve and document calls from members and providers
  • Educate members on healthcare policies and procedures
  • Research inquiries regarding enrollment, eligibility, and benefits
  • Maintain communication with internal and external customers
  • Identify trends in customer inquiries and notify supervisors
TEKsystems logo
TEKsystems Management Consulting Large https://www.teksystems.com/
10001 Employees
HQ: Chicago
See more TEKsystems offers

Job description

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Your missions

Description

Position Description

  • This position is responsible to apply knowledge o company's business, products, members and operations to accurately and effectively fulfill member service requests and inquiries. Ensure adherence to policies and procedures and meet service level expectations by following established guidelines and standards. Achieve fluency in at least one core product or service line
  • Answer, resolve, track and document telephone calls from members, providers, internal departments, and external agencies, in a timely and professional manner. Research, resolve and communicate effectively with internal and external customers regarding member/provider concerns or issues. Educate members and external customers on policies and procedures related to members’ health care program.
  • Research and resolve inquiries from internal /external customers including: Enrollment, eligibility, ID cards, clinic changes, demographic changes, benefit coverage, claims, payments, member reimbursement, and demonstrated knowledge of CAG policies, procedures, and regulations. Utilize appropriate resources to respond to member inquiries.
  • Answer, resolve, track and document telephone calls from members and providers in a timely and professional manner. Interpret member eligibility and coverage through thorough knowledge of the contracts, policies and procedures. Communicate with internal departments, members, providers and other customers regarding the transportation benefit in both verbal and written form, including faxing rides to providers at the appropriate times.
  • Identify trends/issues that emerge in calls/correspondence, and inform Team Lead or Supervisor. Assist in the development and communication of resolutions to internal staff, as requested.
  • Maintain good working relationships and open communication with internal and external customers.


Hours: Monday - Friday, first shift options available

Additional Skills & Qualifications

High school diploma or GED required

2 year degree in health related field, liberal arts, or communication field preferred

Must be a resident of MN, IA, WI, or KS

Benefits

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

Medical, dental & vision

  • Critical Illness, Accident, and Hospital
  • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
  • Life Insurance (Voluntary Life & AD&D for the employee and dependents)
  • Short and long-term disability
  • Health Spending Account (HSA)
  • Transportation benefits
  • Employee Assistance Program
  • Time Off/Leave (PTO, Vacation or Sick Leave)


About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Required profile

Experience

Level of experience: Entry-level / graduate
Industry :
Management Consulting
Spoken language(s):
Check out the description to know which languages are mandatory.

Hard Skills

Soft Skills

  • verbal-communication-skills
  • Customer Service
  • Time Management
  • Problem Solving
  • Teamwork
  • analytical-skills
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