Member Service Rep - Plans

Member Service Representative

The Member Service Representative (MSR) will support multiple lines of business for benefit interpretation, claims, authorizations and membership inquiries. The MSR's primary focus is to answer phone, or email inquiries from providers, members, customers or brokers regarding questions of coverage, claim status, benefit interpretation, billing and/or authorizations. This individual will be proficient in multiple lines of business, for example Medicare, group, and Individual Marketplace, translating health care related terminology into effective verbal or written communication for the end user to comprehend.

In addition to addressing the caller professionally and properly, the MSR will need to document details of the interaction within the database, including any additional action steps taken as follow up.

Education:

Required:

High School Diploma or Equivalent

Experience:

• Experience working in a customer service focused industry strongly desired.
• Health Care/Insurance environment preferred.
• Experience working in a call center preferred.

Skills:

Excellent verbal and written communication skills. Able to work independently and collaboratively in teams. Self starter.