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Member Services Rep I

Company: Christus Health
Location: Irving
Posted on: May 19, 2019

Job Description:

DescriptionThe Customer Service Representative answers all incoming calls from sponsors, members, and providers, researches claim status, and assists in bringing resolution to claim problems. This position is also responsible for maintaining positive relationships with physicians, providers, and practice managers within the provider network. Provides high quality service daily to all callers. Assists with special projects as assigned.MAJOR RESPONSIBILITIESAnswer incoming calls from members and providers and establishing/maintaining good rapport while balancing 2-3 phone queuesProvide accurate information regarding eligibility, benefit verification, network and contract status to callersProvide information to callers concerning claims questions, research as necessary to assist in resolving issues related to claims reimbursementDocument accurate information concerning calls into computer systemMaintain member files, assist with educating, oreintation and credentialing providersMaintain current member demographic information, processing address changes in a timely mannerKeep the commitment to follow up with members and providers within contractually agreed upon time frameConsistently collaborating with all other departments , serving as a provider liaison with focus on provider retentionFollows the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability ACT (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)RequirementsHigh school diploma or GED equivalencyMinimum of 6 months experience in healthcare or medical related fieldGood typing skillsOperating knowledge of computers using multiple programs simutaneouslyGood telephonic skills in order to present information in an accurate and positive mannerExcellent written and oral communictation skillsAbility to work independently and as a positive team player; requires daily direct supervision

Keywords: Christus Health, Irving , Member Services Rep I, Sales , Irving, Texas

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