Member Services Representative

Metropolitan Jewish Health System; New York (NY); On-site; USD 35,000 - 50,000; Full time

Job summary

A leading healthcare organization is seeking a Customer Service Representative to provide high-quality support in a call center environment. The role involves responding to inquiries from members and providers, managing complaints, and processing claims adjustments. Ideal candidates will have strong communication skills and the ability to multitask effectively in a fast-paced setting.

Qualifications

• Minimum 6 months call center experience.
• Ability to manage multiple tasks and work efficiently.

Responsibilities

• Responding to member and provider inquiries.
• Handling requests for adjustments on claim issues.
• Processing requests for disenrollment.

Skills

Communication

Multitasking

Education

High School Diploma

Tools

Microsoft Word

Job description

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.

We are seeking a Customer Service Representative to respond to member and provider inquiries and requests concerning benefits, claims, and complaints within a call center environment, ensuring high-quality customer service to members and providers. Responsibilities include:

1. Receiving calls from members and providers
2. Responding to customer complaints and grievances
3. Recording all calls and details
4. Handling requests for adjustments on claim issues
5. Processing requests for disenrollment

Minimum qualifications include:

• High School Diploma
• Minimum 6 months call center experience
• Proficiency in Microsoft Word
• Excellent telephone communication skills and a professional demeanor
• Ability to manage multiple tasks and work efficiently in a fast-paced environment