MEMBER SERVICE REPRESENTATIVE

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. MEMBER SERVICE REPRESENTATIVE Full Time – Countryside, IL, US Job Overview This position is to serve as the point of contact for both provider and members’ questions and/or concerns regarding benefits, eligibility, referrals, claims, and any other aspect of plan benefits/services. Essential Functions Answer calls from members, dependents, and providers of service Understand and effectively explain all aspects of the Health and Welfare Plan pertaining to eligibility, claim status, and benefit details Respond appropriately and in a timely fashion to member/internal staff/providers by answering telephonic and/or written inquiries concerning benefits, eligibility, referrals, claims, and all other issues following departmental policies and procedures Provide follow-up with members by clarifying the issue, determining the cause, and explaining the solution Escalate member issues to the Escalations Coordinator, Member Advocate, or Management when appropriate Communicate professionally with members, coworkers, and outside vendors for quick resolutions Accurate data entry of time sensitive materials Be present and actively participate in Health and Welfare events Other duties as assigned Education and Experience High School diploma or equivalent 3 – 5 years of prior customer service experience required Specialized Skills / Technical Knowledge Knowledge of medical terminology is required Knowledge of Salesforce or other CRM tools is a plus, but not required Must be detail oriented Ability to handle multiple tasks in a fast-paced setting Ability to work independently and as part of a team Ability to work with other departments as necessary Maintain a pleasant and professional demeanor on the phone and face to face Proficient in Microsoft Office Be able to work Saturday overtime Wage: $31.15 per hour Hours: Monday through Friday 8am to 5pm (scheduled overtime Saturday 8am to noon) (Health and Welfare events vary and could include Saturday and Sunday) #J-18808-Ljbffr