What are the responsibilities and job description for the MEMBER SERVICE REPRESENTATIVE position at Midwest Operating Engineers Fringe Benefit Fund?
Job Overview:
This position is to serve as the point of contact for both provider and members’ questions and/or concerns regarding benefits, eligibility, referrals, claims, and any other aspect of plan benefits/services.
Essential Functions:
• Answer calls from members, dependents, and providers of service
• Understand and effectively explain all aspects of the Health and Welfare Plan pertaining to eligibility, claim status, and benefit details
• Respond appropriately and in a timely fashion to member/internal staff/providers by answering telephonic and/or written inquiries concerning benefits, eligibility, referrals, claims, and all other issues following departmental policies and procedures
• Provide follow-up with members by clarifying the issue, determining the cause, and explaining the solution
• Escalate member issues to the Escalations Coordinator, Member Advocate, or Management when appropriate
• Communicate professionally with members, coworkers, and outside vendors for quick resolutions
• Accurate data entry of time sensitive materials
• Be present and actively participate in Health and Welfare events
• Other duties as assigned
Education and Experience:
• High School diploma or equivalent
• 3 – 5 years of prior customer service experience required
Specialized Skills/Technical Knowledge:
• Knowledge of medical terminology is required
• Knowledge of Salesforce or other CRM tools is a plus, but not required
• Strong communication
• Must be detail oriented
• Ability to handle multiple tasks in a fast-paced setting
• Ability to work independently and as part of a team
• Ability to work with other departments as necessary
• Maintain a pleasant and professional demeanor on the phone and face to face
• Proficient in Microsoft Office
• Be able to work Saturday overtime
Wage: $31.15 per hour
Hours: Monday through Friday 8am to 5pm (scheduled overtime Saturday 8am to noon) (Health and Welfare events vary and could include Saturday and Sunday)
Salary : $31