Member Services Specialist

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