Pleasanton, California
Healthcare Member Services Representative (Pleasanton, CA) Job Opening in Pleasanton, California - BeneSys Administrators is seeking a well-rounded person able to communicate clearly with all levels of clients and professionals.
Under direct supervision, the candidate responds to Member and Provider calls in a courteous and professional manner, answering questions and inquiries regarding membership eligibility, benefits, claims, policies and procedures. Completes forms and other paperwork.
The candidate will also educate members and providers on the guidelines of their healthcare benefits.
Assesses and resolve problems within the scope of authority; escalates complex questions or problems to more experienced representatives or higher authority level.
Works with Claims, Provider Relations and Health Services staff and the ability to work independently and most importantly works very well in a Team oriented environment
Documents all incoming / outgoing calls.
Responds to Provider inquiries through phone contact and/or electronic communications.
Call center hours are 8:00 to 4:00 p.m. Training is provided; however, prior member services experience is preferred. Must have at least two years customer service experience. Medical claims experience a plus.
Competitive salary and benefits.
EEO & ADA
Requirements: Must have excellent communication skills and be capable of taking a high volume of customer calls. Spanish as a second language is a plus. Must be proficient in Microsoft Office, [Word/Excel] with the ability to type 50 wpm. Medical terminology classes, knowledge of medical billing and codes ICD9 and CPT coding is a plus. Must have excellent decision-making, problem-solving, organizational skills and able to work in a ?team? environment.
Job Type: Full-time
Required education:
High school or equivalent
Required experience:
customer service: 2 years
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