Member Services Representative, Sr. Jobs

Addresses more complex health plan or HMO member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for receiving, responding to, and directing member phone calls and written requests. Provides available information upon request and researches or escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines. Requires a high school diploma or equivalent. Typically reports to a supervisor or manager. Works independently within established procedures associated with the s ... pecific job function. Has gained proficiency in multiple competencies relevant to the job. Typically requires 3-5 years of related experience. More
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