Job Details

To respond to member and provider issues and inquiries. Ensures that callers' questions and/or problems are resolved or are directed to the appropriate person for resolution and provides the highest level of customer service. Responsibilities Responds to member and provider issues and questions received in the member services queue. Documents calls as appropriate. Escalates calls to Lead Member Services Representative or Member Services management, as needed. Works with internal departments, providers, and external organizations to resolve issues as needed. Reviews all incoming e-mails to ensure compliance with instructions that impact processes and/or benefits that impact members. Processes enrollment duties as assigned. Enters data in relevant online systems. Other duties as assigned. Qualifications Education and Experience. High school diploma or equivalent; minimum one (1) year Call Center experience in a MCO setting and/or working with the public in a service environment, preferre...Member Services, Member Service, Representative, Customer Service, Retail, Healthcare