Member Services Specialist - Health Plan Support

SGS Consulting; Lake Michigan Beach (MI); Presencial; USD 32.000 - 52.000; Jornada completa

Descripción de la vacante

SGS Consulting in Michigan is seeking a customer service professional to respond to inquiries by phone, mail, and in person, following department standards. The role emphasizes educating members on policies, documenting inquiries, and maintaining HIPAA compliance, with opportunities for training and cross-department collaboration.

Candidates should have at least two years of recent customer service or call center experience and an associate's degree or equivalent; flexibility for varied shifts.

Formación

• Minimum two years in Customer Service or Call Center within last three years.
• Dependable with high integrity and diplomacy.
• Ability to handle inquiries with Privacy and HIPAA compliance.
• Flexibility to work varying shifts including evenings & weekends.
• Proficient with PC and Microsoft Office programs.

Responsabilidades

• Respond to inquiries by telephone, mail and in person with proper documentation.
• Educate members on policies, procedures, product offerings, and coverage provisions.
• Document all inquiries and track member inquiry history and trends.
• Maintain confidentiality in line with HIPAA regulations.
• Seek training to enhance skills and performance.
• Monitor workflow inbox and ensure timely responses to inquiries.
• Interact with support departments to meet member needs.
• Develop relationships across departments and stay updated on policy changes.
• Attend training sessions and pursue continuing education opportunities.
• Interact with providers to obtain information for resolving inquiries.

Conocimientos

Customer service

Call center

Integrity

Problem solving

Communications

Educación

Associate’s degree

Medical Terminology course

Herramientas

MS Office Suite

Descripción del empleo

SGS Consulting in Michigan is seeking a customer service professional to respond to inquiries by phone, mail, and in person, following department standards. The role emphasizes educating members on policies, documenting inquiries, and maintaining HIPAA compliance, with opportunities for training and cross-department collaboration.

Candidates should have at least two years of recent customer service or call center experience and an associate's degree or equivalent; flexibility for varied shifts.