Customer Service Representative, Medicare Advantage - Remote

McLaren Health Care • Flint, MI

226d • Remote

About The Position

We are looking for a Customer Service Representative, Medicare Advantage to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of McLaren Health Care Corporation and is the parent company of McLaren Health Plan in Michigan and MDwise, Inc. in Indiana. It is an organization with a culture of high performance and a mission to help people live healthier and more satisfying lives. McLaren Health Plan and MDwise, Inc., subsidiaries of MIG, value the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plans can thrive. As an employee of MIG, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. McLaren Health Plan is our Michigan-based health plan dedicated to meeting the health care needs of each of our Michigan members. Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org. MDwise is our Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health insurance programs. Learn more about MDwise, Inc. at https://www.mdwise.org.

Requirements

• High School Diploma or equivalent certification.
• One (1) year experience in a customer service related role with direct contact with customers via telephone, email, chat and/or face-to-face.

Nice To Haves

• One (1) year experience in a physician health care office environment or high-volume call center.
• One (1) year experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions.

Responsibilities

• Handle daily member telephone calls, directing members to the proper services needed.
• Educate members about services and benefits.
• Problem solve and create linkages to the Medical Management Department for authorization of services.
• Assist providers with eligibility, benefit, and resolution of claims issues.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Nursing and Residential Care Facilities
• Education Level: High school or GED