Member Service Representative (bilingual)

MEMBER SERVICES REPRESENTATIVE

ProCalls Recruiting (A division of A.W. Companies) is seeking highly professional customer service individuals for an exciting long-term opportunity with a highly respected Health Care company in Minneapolis. This position will handle 100% inbound calls, have a 1st shift schedule and is expected to start on May 21st.

Job Duties

• Responsible for accurately applying knowledge of companies business, products, members and operations to effectively fulfill member service requests and inquiries.
• Ensure adherence to all policies and procedures and meet/exceed service levels by following established guidelines and standards.
• Achieve fluency in at least one core product or service line
• Answer, resolve, track and document telephone calls from members, providers, internal departments, and external agencies, in a timely and professional manner.
• Research, resolve and communicate effectively with internal and external customers regarding member/provider concerns or issues.
• Educate members and external customers on policies and procedures related to members’ health care program.
• Research and resolve inquiries from internal /external customers including: Enrollment, eligibility, ID cards, clinic changes, demographic changes, benefit coverage, claims, payments, member reimbursement, and demonstrated knowledge of CAG policies, procedures, and regulations.
• Utilize appropriate resources to respond to member inquiries.
• Answer, resolve, track and document telephone calls from members and providers in a timely and professional manner.
• Interpret member eligibility and coverage through thorough knowledge of the contracts, policies and procedures.
• Communicate with internal departments, members, providers and other customers regarding the transportation benefit in both verbal and written form, including faxing rides to providers at the appropriate times.
• Identify trends/issues that emerge in calls/correspondence, and inform Team Lead or Supervisor.
• Assist in the development and communication of resolutions to internal staff, as requested.

Required Experience

• One to two years call center experience or two years customer service experience.
• Preference given to candidates with health insurance (HMO), physician group practice, or community agency.
• Proficient PC skills required
• Knowledge of Microsoft office

Preferred Experience

• Working knowledge of medical claims and/or medical billing processes is preferred.
• Proficient computer skills; knowledge of Microsoft office, Amisys, and MACESS type software packages.
• Bilingual (English, Hmong, Somoli, Spanish)

Education

• Required: High school graduate or the equivalent
• Preferred: Two-year degree in health related, liberal arts or communication field, including a course in medical terminology

Company Information

Client company is proud to be a recognized Star Tribune Top Workplace for the 8th consecutive year. As a part of their collaborative team, you’ll experience the rewards that come with helping others and seeing the positive results of your hard work. Company values and respects each individual’s ideas and contributions, and give you the freedom to grow both personally and professionally. Company is centrally located, and offers onsite education, equipment and wellness resources, a myriad of volunteer activities, and a number of other rewards. If you’re looking for a welcoming environment that celebrates what you have to offer, helps you build on your strengths, and gives you the opportunity to truly make a difference, we invite you to apply.

Job Type: Full-time

Salary: $15.00 to $17.00 /hour

Experience:

• Call Center: 1 year