Medical Services Representative

University Health System- San Antonio; San Antonio (TX); On-site; USD 34,000 - 48,000; Full time

Job summary

University Health System- San Antonio is seeking a Member Services Liaison to resolve member and provider inquiries by phone and email, delivering accurate information and documenting interactions while upholding HIPAA policies.

The role requires a high school diploma with college coursework in business or health care administration; prior HM0 experience and healthcare problem resolution experience are preferred. Strong communication and customer service skills are essential.

Qualifications

• High school graduation or its equivalency is required.
• One year of college level courses in business, health care administration or related courses is preferred.
• Minimum of one-year HMO experience is preferred.
• Health care problem resolution experience is preferred.

Responsibilities

• Acts as liaison to members and providers to resolve member services issues.
• Provides information to Community First Health Plan members by phone.
• Ensures HIPAA-related policies are followed in all aspects of Member Services operations.

Skills

Customer service

Phone support

HIPAA compliance

Clear communication

Education

High school diploma

College coursework in business/health care

Job description

POSITION SUMMARY/RESPONSIBILITIES

Serves as a liaison to members and providers in resolving member services issues. Provides information to Community First Health Plan members by phone. Ensures compliance with the Health Insurance Portability and Accountability Act (HIPAA) related policies in regards to all aspects of operations within Member Services.

EDUCATION/EXPERIENCE

High school graduation or its equivalency is required. One year of college level courses in business, health care administration or related courses is preferred. Minimum of one-year HMO experience is preferred. Health care problem resolution experience is preferred.