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Member Services Representative I

Role overview

Qualifications

  • 0 - 2 years of direct experience in healthcare, insurance, Union, or community engagement
  • Spanish bilingual required
  • Experience with multi-cultural communities
  • Associate's degree in Healthcare or related field or equivalent work experience required

Responsibilities

  • Serves as the main point of contact for members, unions, employers, providers, and vendors
  • Receives and records inquiries regarding plan benefits, claims and eligibility
  • Encourages members to participate in health improvement programs
  • Researches benefit, eligibility and claim issues and initiates corrective action

Key facts

Hard skills

Other skills

  • Customer Service
  • Communication
  • Problem Solving
  • Teamwork

About the company

UNITE HERE HEALTH logo

UNITE HERE HEALTH

Health Insurance (Payers)

UNITE HERE HEALTH is a multi-employer Taft-Hartley Trust Fund governed by a Board of Trustees composed of union and employer representatives. Our mission is to provide health benefits that offer high-quality, affordable healthcare to our participants at better value with better service than is otherwise available in the market. We believe our success depends on innovation and on engaging our participants. For several decades, UNITE HERE HEALTH has served UNITE HERE! union workers in the hospitality, food service and gaming industries. Our benefits and innovative programs are designed to meet the triple aim of better care, better health, and lower costs while empowering our participants to better manage their health and healthcare.

Company details

Company typeScaleup
IndustryHealth Insurance (Payers)
Company size201 - 500

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Job description

UNITE HERE HEALTH serves 190,000+ workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!

The Member Service Representative I position is to be the face of the fund, especially to members and to provide benefit, eligibility, claim and health care education, information, and issue resolution to a multi-cultural community. The Member Services Representative shares the UNITE HERE HEALTH message by encouraging the utilization of benefits according to plan benefits and best healthcare value, while optimizing the member’s service experience.

ESSENTIAL JOB FUNCTIONS AND DUTIES

  • Serves as the main point of contact for the Fund’s members, unions, employers, providers, and vendors on benefit, claims and eligibility issues, education and questions.
  • Receives and records telephone and walk-in inquiries regarding plan benefits, claims and eligibility.  
  • Performs enrollment functions, including telephonic and in-person outreach.
  • Encourages members to take steps to get involved in programs to improve their health Recognizes and communicates issues to management including trends and anomalies.
  • Research benefit, eligibility and claim issues and initiates corrective action with relevant departments.
  • Maintains up-to-date knowledge of all systems and sources relating to plan benefits, processes, policies, etc. that will affect performance of daily tasks.
  • Assists in member outreach, including telephonic and face to face in the Fund office, union office and worksites.
  • Participates in benefit presentations.
  • Assists in daily office operations. 

ESSENTIAL QUALIFICATIONS

  • 0 - 2 years of direct experience minimum in healthcare, insurance, Union, or community engagement environment
  • Spanish bi-lingual required
  • Experience with multi-cultural communities
  • Working knowledge and experience in customer service duties in person and/or over the phone
  • Experience in call center preferred
  • Associate's degree in Healthcare or related field or equivalent work experience required
  • The ability to travel 10% ~ 15%

Salary range for this position: Hourly $18.87 - $23.13. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location.

Work Schedule (may vary to meet business needs): Monday~Friday, 7.5 hours per day (37.5 hours per week) with potential for hybrid work-from-home arrangement.

We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Pension, Short- & Long-term Disability, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP).

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Marcus Rivera

Chief Revenue Officer

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linkedin.com/in/marcusrivera
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