Member Service Representative

Corporate Square; San Antonio (TX); On-site; USD 35,000 - 45,000; Full time

Job summary

A leading company in the health care sector is seeking a Member Services Representative to serve as a liaison to members and providers, resolving issues and ensuring compliance with regulations. The role involves providing information and support to health plan members via phone, requiring strong communication skills and a foundational education in health care or business.

Qualifications

• High school graduation or its equivalency required.
• One year of college level courses in business, health care administration or related preferred.

Responsibilities

• Liaison to members and providers in resolving member services issues.
• Provides information to Community First Health Plan members by phone.
• Ensures compliance with HIPAA related policies.

Skills

Problem Resolution

Communication

Education

High school diploma or equivalent

One year of college level courses

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.