Member Service Representative| Medicare |Bilingual|

Job highlights
Identified by Google from the original job post
Qualifications
Call center: 1 year (Required)
BOTH English and Spanish {MANDATORY} (Required)
Benefits
Pay: $18.00 - $20.00 per hour
Expected hours: 40 per week
401(k)
Dental insurance
Health insurance
Paid time off
Paid training
Vision insurance
8 hour shift
Responsibilities
Membership Representative responds to incoming calls and may initiate outgoing calls, providing customer service to plan members and providers by answering benefit questions, resolving issues and educating callers
Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions and/or concerns received by phone or mail
Receives, distributes and tracks all incoming enrollment applications and plan change requests
Conducts quality review of enrollment applications and plan change requests received from beneficiaries, the Sales Department, and the Centers for Medicare and Medicaid Services (CMS) and conducts necessary outreach and research to address all identified discrepancies
Performs end-of-day reconciliation of processed enrollments, plan change requests, disenrollment's and cancellations
Processes voluntary disenrollment and cancellation requests
Generates member communications within required timeframes and conducts intermittent quality reviews
Processes return mail (including scanning) and assists with researching invalid address information
Bills, collects premiums and reconciles payments
Notifies clients of premium discrepancies through payment adjustment notices
. Screens all forms and data for all paperwork received from Sales
Thoroughly documents inquiry outcomes for accurate tracking and analysis
Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner
Complies with State and Federal regulations and guidelines and enterprise policies and procedures pertaining to member privacy and confidentiality of protected health information (PHl) and personally identifiable information (Pll)
Assists with a variety of special projects as defined by the Membership Department Manager
Performs basic job functions with help from co-workers, specialists and managers on non-basic issues
Job Type: Full-time
Job description
- Membership Representative responds to incoming calls and may initiate outgoing calls, providing customer service to plan members and providers by answering benefit questions, resolving issues and educating callers.

Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions and/or concerns received by phone or mail.

. Receives, distributes and tracks all incoming enrollment applications and plan change requests.

. Conducts quality review of enrollment applications and plan change requests received from beneficiaries, the Sales Department, and the Centers for Medicare and Medicaid Services (CMS) and conducts necessary outreach and research to address all identified discrepancies.

. Performs end-of-day reconciliation of processed enrollments, plan change requests, disenrollment's and cancellations.

. Processes voluntary disenrollment and cancellation requests.

. Generates member communications within required timeframes and conducts intermittent quality reviews

. Processes return mail (including scanning) and assists with researching invalid address information.

. Bills, collects premiums and reconciles payments.

Notifies clients of premium discrepancies through payment adjustment notices. . Screens all forms and data for all paperwork received from Sales.

. Thoroughly documents inquiry outcomes for accurate tracking and analysis.

. Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.

. Complies with State and Federal regulations and guidelines and enterprise policies and procedures pertaining to member privacy and confidentiality of protected health information (PHl) and personally identifiable information (Pll).

Assists with a variety of special projects as defined by the Membership Department Manager.

. Performs basic job functions with help from co-workers, specialists and managers on non-basic issues.

Job Type: Full-time

Pay: $18.00 - $20.00 per hour

Expected hours: 40 per week

Benefits:
• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Paid training
• Vision insurance

Schedule:
• 8 hour shift

Experience:
• Call center: 1 year (Required)

Language:
• BOTH English and Spanish {MANDATORY} (Required)

Work Location: In person