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Medi-Cal Member Services Representative

Company: Helpmates Staffing
Location: Orange
Posted on: January 7, 2019

Job Description:

Medi-Cal Member Services Representative We are a health management organization that is dedicated to changing the way health care is delivered in our community. We are a growing, dynamic health organization that is looking to improve our members experience and that starts with you. We seek dedicated, innovative individuals who thrive in a high volume environment to join us and vision and transform health care. The Member Services Representative assists plan members with their concerns or complaints and provides the necessary information and education to resolve concerns. To perform this job successfully, you must be able to perform each essential task satisfactorily. Must have high energy, positive attitude and desire to help our Members! Explain the heath care plan's procedures, protocols, benefits, and services via telephone Facilitate member requests for changes with network provider, transportation requests, or any other member request for assistance (within appropriate guidelines ) Answer incoming member phone calls within the goal time frame. Document every incoming call during the course of the call with pertinent details (i.e., caller name, contact info, reason for call, action taken, resolution, etc.,) Make every effort to resolve any member dis-enrollment and cancellation requests, complaint and grievances, and assist the member with their questions or concerns. Perform other duties to support the over all team goal or as assigned by the department Manager. IND1 Job Requirements High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience. Associate degree (A.A.) degree (preferred). Two years customer service/telemarketing experience. Medical front office experience. Direct sales or related experience, preferably in the Medi-Cal, Commercial, or Medicare Managed Care industry. Knowledge of Medi-Cal, Commercial, and Medicare Managed Care Plans. Bilingual (English/Spanish) Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization. Additional Information We will consider for employment all qualified Applicants, including those with Criminal Histories, in a manner consistent with the requirements of applicable state and local laws, including the California Fair Employment and Housing Act (FEHA). Category: Customer Service , Keywords: Customer Service Representative

Keywords: Helpmates Staffing, Orange , Medi-Cal Member Services Representative, Sales , Orange, California

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