Member Services Representative -Healthcare
Johnson Service Group
Johnson Service Group is seeking Member Services Representatives. This is a remote position. Must live in Texas, New Mexico, Nevada, Arizona or CA.
Bilingual Required: Mandarin, Cantonese, Korean, Vietnamese, Spanish.
Work schedule:
Training: 7 weeks M-F, 8:00am-4:00pm
Work hours available: 6am-8pm, PST weekend rotation and some holiday's required.
Pay rate: $21/hr. Bilingual
Pay rate: $20/hr. Non-Bilingual
Job Summary:
Serves members by being an advocate and point of contact for member questions and concerns regarding benefits, eligibility, referrals, claims and any other aspects of plan benefits and services. Ensures member satisfaction by providing superior customer service and willingness to help at all time while maintaining a professional demeanor.
Responsibilities: Provides quality customer service: Educates members, family, providers and caregivers regarding benefits and plan options. Accurately explains benefits and plan options in person, via email or telephonically. Provides follow-up with members by clarifying the customer’s issue, determining the cause, and identifying and explaining the solution. Escalates appropriate member issues to management or other departments as required. Consistently meets and/or exceeds the departmental standards, including, but not limited to: quality, productivity, and adherence to schedule and attendance. Responds appropriately and in a timely fashion to member/internal staff/providers by answering telephonic and written inquiries concerning benefits, eligibility, referrals, claims and all other issues following departmental policies and procedures and job aids. Takes ownership of the issue, focusing on providing solutions and options for members, as necessary through resolution of member issue. Increases member satisfaction by following up and resolving member issues, complaints, and questions in an efficient, timely and accurate fashion; coordinates resolution with providers and other departments as needed. Participates in member calling projects as assigned by management to support the overall goal of membership retention. Follows all appropriate Federal and State regulatory requirements and guidelines applicable to company operations, as documented I company policies and procedures. Follows all HIPAA requirements. Documents transactions by completing applicable member forms and summarizing actions taken in appropriate computer system and following standards set by the department or by other authorized individuals. Temporarily responds to routine member questions and concerns on specific medical group call queues as part of skill development. Contributes to team effort by accomplishing related results as needed. Other duties as assigned. Requirements: Bilingual Requirement: Korean, Mandarin, Cantonese, Vietnamese, Spanish 1-2 years call center or related customer service experience, required. 1-2 years of prior experience with Medicare benefits, including Medicare Advantage Plans preferred. Experience in the healthcare, insurance or pharmacy industry is highly desirable. Ability to maintain calm demeanor at all times, including during highly charged situations. Data entry and general computer skills (word processing, e-mail) required. Effective communication (oral and written) skills. Professional/pleasant telephone manner required. Ability to handle large call volume, while providing excellent customer service at all times required. Demonstrated efficiency/effectiveness in an environment with a high call volume. JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more. Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law. #D800
Bilingual Required: Mandarin, Cantonese, Korean, Vietnamese, Spanish.
Work schedule:
Training: 7 weeks M-F, 8:00am-4:00pm
Work hours available: 6am-8pm, PST weekend rotation and some holiday's required.
Pay rate: $21/hr. Bilingual
Pay rate: $20/hr. Non-Bilingual
Job Summary:
Serves members by being an advocate and point of contact for member questions and concerns regarding benefits, eligibility, referrals, claims and any other aspects of plan benefits and services. Ensures member satisfaction by providing superior customer service and willingness to help at all time while maintaining a professional demeanor.
Responsibilities: Provides quality customer service: Educates members, family, providers and caregivers regarding benefits and plan options. Accurately explains benefits and plan options in person, via email or telephonically. Provides follow-up with members by clarifying the customer’s issue, determining the cause, and identifying and explaining the solution. Escalates appropriate member issues to management or other departments as required. Consistently meets and/or exceeds the departmental standards, including, but not limited to: quality, productivity, and adherence to schedule and attendance. Responds appropriately and in a timely fashion to member/internal staff/providers by answering telephonic and written inquiries concerning benefits, eligibility, referrals, claims and all other issues following departmental policies and procedures and job aids. Takes ownership of the issue, focusing on providing solutions and options for members, as necessary through resolution of member issue. Increases member satisfaction by following up and resolving member issues, complaints, and questions in an efficient, timely and accurate fashion; coordinates resolution with providers and other departments as needed. Participates in member calling projects as assigned by management to support the overall goal of membership retention. Follows all appropriate Federal and State regulatory requirements and guidelines applicable to company operations, as documented I company policies and procedures. Follows all HIPAA requirements. Documents transactions by completing applicable member forms and summarizing actions taken in appropriate computer system and following standards set by the department or by other authorized individuals. Temporarily responds to routine member questions and concerns on specific medical group call queues as part of skill development. Contributes to team effort by accomplishing related results as needed. Other duties as assigned. Requirements: Bilingual Requirement: Korean, Mandarin, Cantonese, Vietnamese, Spanish 1-2 years call center or related customer service experience, required. 1-2 years of prior experience with Medicare benefits, including Medicare Advantage Plans preferred. Experience in the healthcare, insurance or pharmacy industry is highly desirable. Ability to maintain calm demeanor at all times, including during highly charged situations. Data entry and general computer skills (word processing, e-mail) required. Effective communication (oral and written) skills. Professional/pleasant telephone manner required. Ability to handle large call volume, while providing excellent customer service at all times required. Demonstrated efficiency/effectiveness in an environment with a high call volume. JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more. Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law. #D800
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