Health Plan Member Representative

Healthcare Ascension; Troy (MI); Remote; USD 60,000 - 80,000; Full time

Job summary

Join a forward-thinking organization as a Health Plan Member Representative, where you'll play a crucial role in transforming healthcare. In this fully remote position, you will engage with customers, providing essential information and resources while ensuring accurate benefit calculations. With a commitment to community well-being and a supportive environment, this role offers a unique opportunity to make a positive impact. Enjoy a comprehensive benefits package, including paid time off, health insurance options, and a sign-on bonus. If you're passionate about healthcare and customer service, this is the perfect chance to advance your career.

Benefits

Paid Time Off (PTO)

Health Insurance Options

Retirement Benefits

Tuition Reimbursement

Employee Assistance Programs

Parental Leave

Adoption Assistance

Sign-on Bonus

Qualifications

• High School diploma or equivalent required.
• 1 year of healthcare call center experience preferred.

Responsibilities

• Answer incoming calls and perform triage of inquiries.
• Collect and track relevant caller data for reporting activities.
• Verify and audit benefit calculations with high accuracy.

Skills

Healthcare Claims Knowledge

Customer Service

Data Collection and Analysis

Communication Skills

Education

High School Diploma or Equivalent

1 Year of Applicable Job Experience

Job description

Details Salary: from $19.50 an hour Sign-on Bonus: up to $500.00 Department: Member Services, SmartHealth, Call Center Schedule: Full-Time, 8-hour day shift, Monday - Friday, fully remote Facility: Automated Benefit Services (ABS) Sign-on Bonus based on eligiblity Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension. *Please note, benefits and benefits eligibility can vary by position, exclusions may apply for some roles (for example: PRN, Short-Term Option, etc.). Connect with your Talent Advisor today for additional specifics. Responsibilities As a Health Plan Member Representative, you'll answer incoming calls and perform triage of inquiries. Respond to telephone and/or Internet inquiries from customers seeking information and/or resources, following a set standard. Collect relevant caller data to assist with measurement, tracking and reporting activities. Track inquires, questions and answers and provide resolution. Perform additional clerical duties as assigned. Calculate pension benefits and payment worksheets with a high degree of accuracy. Verify and audit benefit calculations and payment worksheets completed by peers. Research pension plan provisions and pension law to ensure accurate completion of pension benefit calculations, with ability to articulate plan provisions to participants. Collect, review and reconcile participant data and resolve data issues. Independently manage workload and handle multiple tasks to ensure timely completion of work assignments. Knowledge of healthcare claims, Medicaid and Medicare. Requirements Education: High School diploma equivalency OR 1 year of applicable cumulative job specific experience required. Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable. Additional Preferences Additional Preferences: 1 year of healthcare call center experience, preferred. FACET experience, preferred. Why Join Our Team Ascension associates are key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join us and help us drive impact through reimagining how we can deliver a people-centered healthcare experience and creating the solutions to do it. Explore career opportunities across our ministry locations and within our corporate headquarters. Ascension is a leading non-profit, faith-based national health system made up of over 150,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states. Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you. Equal Employment Opportunity Employer Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster. Pay Non-Discrimination Notice Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants. This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information. E-Verify
Education: High School diploma equivalency OR 1 year of applicable cumulative job specific experience required. Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable.
As a Health Plan Member Representative, you'll answer incoming calls and perform triage of inquiries. Respond to telephone and/or Internet inquiries from customers seeking information and/or resources, following a set standard. Collect relevant caller data to assist with measurement, tracking and reporting activities. Track inquires, questions and answers and provide resolution. Perform additional clerical duties as assigned. Calculate pension benefits and payment worksheets with a high degree of accuracy. Verify and audit benefit calculations and payment worksheets completed by peers. Research pension plan provisions and pension law to ensure accurate completion of pension benefit calculations, with ability to articulate plan provisions to participants. Collect, review and reconcile participant data and resolve data issues. Independently manage workload and handle multiple tasks to ensure timely completion of work assignments. Knowledge of healthcare claims, Medicaid and Medicare.