Member services agent

The member services agent is responsible for providing effective customer service for all internal and external customers by using excellent, in-depth knowledge of company products and programs as well as communicating effectively with team members within the customer service department. Inbound calls 40 - 60 on average.


salary: $18 - $19 per hour
shift: First
work hours: 8 AM - 4 PM
education: High School

Responsibilities

• Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction. Confer with customers by telephone to provide information about Rx claims processing.
• Keep detailed records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.
• Follow-up to ensure that appropriate changes were made to resolve customers' problems.
• Refer unresolved customer grievances to designated departments for further investigation.
• Review Rx insurance policy terms to determine whether a claim is covered for employer group.
• Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments.
• Resolve customers' service or billing complaints.
• Obtain and examine all relevant information to assess validity of complaints and to determine possible causes.
• Abide by all obligations under HIPAA related to Protected Health Information (PHI).
• If a HIPAA violation is discovered, whether individually or by another, you must report the violation to the Compliance Officer and/or Human Resources.
• Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company.

Skills

• HIPAA
• Customer Service
• Call Center

Qualifications

• Years of experience: 0 years
• Experience level: Entry Level

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.


Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on click.appcast.io.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.