Member Service Representative
LHH, Sacramento, CA, United States
Member Service Representative
As a Member Service Representative you will be the go-to resource for members and providers who need support navigating health plans, services, and benefits. You'll play a key role in ensuring timely, accurate, compassionate service by: Recording and routing appeals and grievances according to established procedures. Educating members on referral processes, online tools, and key resources. Assisting members, providers, brokers, and partners with claims or billing inquiries. Collaborating across departments to resolve issues within required timeframes. Managing challenging conversations with professionalism, empathy, and tact. Reporting system or call-related issues requiring urgent attention. Providing courteous, informed support to all individuals encountered in your work. Qualifications High School Diploma. A minimum of 2 years of experience working in a call center A minimum of 3 years of previous experience working in the healthcare industry (required), HMO experience is a plus. Basic computer skills, including electronic mail, routine databases, word processing, spreadsheets, graphics, Salesforce, Genesis, etc. Ability to type 40 WPM or higher Bilingual in any language is a plus! Eligible for hybrid work post training 4-6 months. Pay Details: $22.00 to $25.00 per hour Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply
As a Member Service Representative you will be the go-to resource for members and providers who need support navigating health plans, services, and benefits. You'll play a key role in ensuring timely, accurate, compassionate service by: Recording and routing appeals and grievances according to established procedures. Educating members on referral processes, online tools, and key resources. Assisting members, providers, brokers, and partners with claims or billing inquiries. Collaborating across departments to resolve issues within required timeframes. Managing challenging conversations with professionalism, empathy, and tact. Reporting system or call-related issues requiring urgent attention. Providing courteous, informed support to all individuals encountered in your work. Qualifications High School Diploma. A minimum of 2 years of experience working in a call center A minimum of 3 years of previous experience working in the healthcare industry (required), HMO experience is a plus. Basic computer skills, including electronic mail, routine databases, word processing, spreadsheets, graphics, Salesforce, Genesis, etc. Ability to type 40 WPM or higher Bilingual in any language is a plus! Eligible for hybrid work post training 4-6 months. Pay Details: $22.00 to $25.00 per hour Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply