Member Services Representative

TEKsystems
$18.25 / hr
life insurance, sick time, 401(k), retirement plan
United States, Wisconsin, Brookfield
Jan 29, 2025
The Member Experience Representative's primary focus is to answer phone or email inquiries from providers, members, customers, or brokers regarding questions of coverage, claim status, benefit interpretation, billing, and/or authorizations. The representative must be proficient in one line of business, either Medicare or Group/Marketplace, translating healthcare-related jargon into effective written or verbal communication for the end user to comprehend. Key Responsibilities: * Answer incoming phone calls from members, customers, providers, or brokers efficiently regarding their inquiries on coverage, claim status, benefit interpretation, billing, and/or authorizations. * Respond to inquiries within set timeframes to adhere to department metrics and contractual standards. * Document details of the interaction within the database, including any additional action steps taken as follow-up. * Appropriately apply all organizational, regulatory, and credentialing principles, procedures, requirements, regulations, and policies. * During telephone calls, probe and ask appropriate questions to identify specifics of what the caller is inquiring about to ensure first call resolution. * Follow-up with customers or other departments on any outstanding issues or concerns. Escalate appropriate issues to Supervisor or appropriate individual. * Support our members by answering calls and proactively work to resolve their questions and concerns. * Strive for first call resolution, working to resolve member issues at the point of contact. * Use dual monitors while leveraging computer-based resources to find answers to customers' questions and help simplify next steps for members. Additional Skills & Qualifications: * Experience working in a call center preferred. * Knowledge of basic insurance concepts preferred. * Intermediate skills in Microsoft Office, including Outlook, Excel, and Word. Employee Value Proposition (EVP): * After hire raises: There is a wage escalator based on metrics, which will be covered. * Tons of internal growth. Once hired on, there is room for growth outside of the Member Service Rep role. Training / Work Schedule: * The initial training period is a 6-8 week program with a work schedule of Monday - Friday from 8:00 am - 4:30 pm. * After your training, you can select a Monday - Friday work schedule of either 8:30 am to 5:00 pm or 9:00 am - 5:30 pm. Pay and Benefits The pay range for this position is $18.25 - $18.25/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Feb 7, 2025. About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.