Description:

• The Member Experience Representative’s primary focus is to answer phone, or email inquiries from providers, members, customers or brokers regarding questions of coverage, claim status, benefit interpretation, billing and/or authorizations.

• Proficient in one line of business, either Medicare or Group/Marketplace, translating health care related jargon into effective written or verbal communication for the end user to comprehend.

• Document details of the interaction within the database, including any additional action steps taken as follow up.

• Demonstrate commitment and behavior aligned with the philosophy, mission, values and vision of Network Health

• Appropriately apply all organizational, regulatory, and credentialing principles, procedures, requirements, regulations, and policies

• Answer incoming phone calls from members, customers, providers or brokers efficiently regarding their inquiries on coverage, claim status, benefit interpretation, billing and/or authorizations. Respond to inquiries within set timeframes to adhere to department metrics and contractual standards.

• During telephone call, probe and ask appropriate questions to identify specifics of what caller is inquiring about to ensure first call resolution.

• Follow-up with customers or other departments on any outstanding issues or concerns. Escalate appropriate issues to Supervisor or appropriate individual.

Top Skills Details:

• Call center experience needed

• insurance

• Medicare experience needed

• group insurance

• benefit interpretation

• claims

Pay:

• $17 to $18.25

Training:

• Monday to Friday

• 8am to 4pm

• 6 to 8 weeks

Shift:

• Monday to Friday

• 8:30am to 5pm

• 9am to 5:30pm

Location:

• Remote

  About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.