Health Plan Member Support Specialist

McLaren Health Care; Flint (MI); On-site; USD 32,000 - 42,000; Full time

Benefits offered by this job

Full-time schedule

Job summary

McLaren Health Plan (MHP) is a managed care organization serving Michigan residents with multiple product lines, including Medicaid and Medicare plans. The Customer Service Representative will handle daily member calls, educate members, address questions, and connect to the Medical Management Department for service authorization.

Preferred candidates will have experience in health care offices or high-volume call centers and knowledge of HMO, PPO, TPA and managed care functions; high school

Qualifications

• High School Diploma or equivalent certification.
• One year experience in a customer service related role with direct contact with customers via telephone, email, chat and/or face-to-face.
• Preferred: One year experience in a physician health care office environment or high-volume call center; knowledge of HMO, PPO, TPA, PHO and Managed Care functions.

Responsibilities

• Daily member telephone calls directing members to proper services and educating members; create linkages to Medical Management for authorization of services.
• Assist providers with eligibility, benefits and resolution of claims issues.

Skills

Customer service

Phone support

Communication

Multitasking

Education

High School Diploma

Job description

McLaren Health Plan (MHP) is a managed care organization serving Michigan residents with multiple product lines, including Medicaid and Medicare plans. The Customer Service Representative will handle daily member calls, educate members, address questions, and connect to the Medical Management Department for service authorization.

Preferred candidates will have experience in health care offices or high-volume call centers and knowledge of HMO, PPO, TPA and managed care functions; high school