Member Services Representative

Imperial Management Administrators Services

Under general supervision, following established procedures, assist and direct patients and or providers in an empathetic and caring manner, efficiently and timely, and complete appropriate documentation. Respond to provider inquiries and attempt to resolve provider concerns or refer to management for resolution.

ESSENTIAL JOB FUNCTIONS:

Answers phone calls and written questions, concerns, and complaints to include, but not limited to: members, providers, health plan, insurance brokers, and hospitals in accordance with HIPAA guidelines.
Comply with UM, claims, and member service policy and procedures.
Maintain an average handled time of no more than 10 minutes
Maintain an average of wait time to 2 minutes or less.
Assist in identifying and solving member/agent needs, issues and inquiries.
Document accurately all inquiries in the plans databases(s).
Ability to communicate to member needs for services using insightful, probing questions and demonstrates superior listening skills.
Ability to give member eligibility and provides benefit related information to members and/or providers.
Ability to communicate with contracted providers about turn around times, portal access, benefits and all other information as needed.
Adheres to payroll policies and properly uses timekeeping system with minimal manual changes.

Maintains regular and consistent attendance.

Member Services Representative assist management with other duties as assigned, as well as supporting other departments when needed.

Adheres to Compliance Plan and HIPAA regulations.

EDUCATION/EXPERIENCE:

·         High school graduate or equivalent.

·         1-year customer service/sales experience required

·         1-year experience dealing with high volume of calls and e-mails

·         1-year healthcare related experience in managed care environment to include but not limited to IPA, MSO or Health Plan

Must be able to Type 40 or more WPM

SKILLS/KNOWLEDGE/ABILITY:

Microsoft Word and Excel

To apply for this job please visit forms.office.com.