Member Service Representative

US-NY-New York
2 months ago
Job ID
2017-11030
# Positions
1
ArchCare Catholic Resources, Inc.
Experience (Years)
1
Category
Customer Service
Work Days Per Week
5
Shift
D
Shift Start Time
9:00am
Shift End Time
5:00pm
Type
Full-Time
# Hours
35

Overview

As a member of the ArchCare MCO Customer Service team, the Customer Service Representative is responsible for answering questions from members, prospective members and providers regarding a wide range of topics including services available through the ArchCare benefit plans, interpretation of health plan benefits according to the member’s enrolled benefit and specific situation and provide specific information regarding providers. They act as an advocate for ArchCare customers (member, provider, facilities, etc.) by providing guidance, interpretation, and education on benefit coverage levels, claims payment, and various program inquires. The Member Services Representative will also provide information to Providers concerning their member’s coverage, network and benefits. The customer service representation will access and work with multiple applications & computer screens to research & address these questions. The customer service representative will investigate and assist in the resolution of customer concerns regarding any service provided or prompt access to medical care. This will include coordinating issue resolution with other internal departments on behalf of the member

Responsibilities

Interact with health plan members through outbound and inbound telephonic contact to review

Qualifications

High School Diploma or equivalent

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