Member Services Representative Responsibilities and QualificationsServe as a primary point of contact for members, providing timely, accurate, and professional assistance.Manage a high volume of inbound calls while maintaining excellent customer service.Answer questions regarding eligibility, benefits, coverage, referrals, provider networks, and plan operations.Research member information across multiple systems to resolve questions, concerns, and complaints.Accurately document all member interactions and track inquiries through final resolution.Coordinate with members, healthcare providers, and internal departments to address service needs.Protect confidential information and follow all applicable privacy, compliance, and regulatory requirements.Demonstrate strong communication, interpersonal, problem-solving, data-entry, and organizational skills.Ability to multitask, work independently, and remain professional in a fast-paced environment.Associate' s degree or 6- 12 months of related education, training, or work experience required.Previous experience in a call center, medical office, health plan, or healthcare environment is preferred.
Not specified in the original listing.
Not specified in the original listing.
