Member Services Representative

If you are looking for a customer service based position that has a variety of clerical duties, offers a flexible schedule, and the opportunity to work from home if desired, your search is over!

Medical Associates Health Plans is looking for a full-time Member Services Representative to join our team!

Who You Are:

• Dedicated to providing superior customer service
• Able to adapt to various customers and their needs
• Have excellent verbal communication
• Comfortable learning and navigating various computer programs and phone queues
• Excited to work closely with team members in a fast-paced environment

Work Schedule: Monday through Friday, 8:00am to 5:00pm for training period. Opportunity for work from home after training if desired!

• Single or Family Health Insurance with discounted premium rates for wellness program participation.
• 401k with immediate matching (50% on the dollar up to 7% of pay + additional annual Profit Sharing
• Flexible Paid Time Off  Program (24 days off/year)
• Medical and Dependent Care Flex Spending Accounts
• Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc.

What You'll Be Doing:

• Respond to phone, in-person, written or e-mail inquiries from members, employers, brokers, providers, pharmacies as well as internal customers, in accordance with department standards. Perform research on inquiries and resolve; educate members on benefits, Explanation of Benefit forms, the use of the website and other tools and documents utilized by members.
• Possess knowledge and ability to communicate to internal and external customers regarding benefit plans, including medical, prescription drug and other employee benefit plans offered
• Interpret and enter necessary data and documentation into member and authorization subsystems of core business processing system as necessary to support the member services department; possess knowledge to examine, process, calculate and administer claims according to internal processing guidelines.
• Assist in review and resolution of complaints, appeals and grievances as needed.
• Complete all additional assigned projects and duties.

Knowledge, Skills and Abilities:
Experience: One to three years of similar or related experience.

Education: High school diploma or GED required.

Other Skills: Excellent telephone presence. Familiar with Microsoft Office applications, particularly Word and Excel.