Member Services Representative

Community First Health Plans; San Antonio (TX); On-site; USD 32,000 - 42,000; Full time

Job summary

Community First Health Plans in San Antonio, TX is seeking a dedicated Member Services Liaison to resolve member and provider issues by phone and to help ensure HIPAA compliance across all member services operations. Required: high school diploma or equivalent.

Preferred: one year of college courses in business or health care administration and at least one year of HMO experience, plus health care problem resolution experience.

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

• 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 HIPAA related policies in regards to all aspects of operations within Member Services.

Education

High school diploma or equivalent

One year of college-level courses in business/health care administration or related courses

Minimum of one-year HMO experience

Health care problem resolution experience

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.