Member Services Representative-Temp
About The Position
The Member Services Representative (MSR) serves enrollees in California, Florida and Georgia who are enrolled in AHF's Medicare and Medi-Cal managed care plans. The MSR answers enrollee, prospective enrollee and AHF Healthcare Center patient calls, emails and electronic chats coming into the Member Services and AHF Patient Relations call center. He or she also answers provider calls regarding enrollee eligibility or claims status enquiries. The MSR actively supports enrollment and eligibility processing functions and enrollee materials distribution. The MSR answers incoming contacts to the call center to meet contractual and regulatory requirements for call center operations that support Medicare and California Medi-Cal managed care plans. He or she participates in the Member Services Department's processes to meet enrollment and disenrollment timeliness; complaint, grievance and appeal intake documentation and acknowledgement; and enrollee non-emergency transportation booking rules. The MSR demonstrates his or her success in this role by contributing to Member Services operation so it complies with Centers for Medicare and Medicaid Services (CMS) and California Department of Health Care Services, regulations, yet delivers thorough service to enrollees and providers in a professional, competent and compassionate manner.
Responsibilities
- answers enrollee, prospective enrollee and AHF Healthcare Center patient calls, emails and electronic chats coming into the Member Services and AHF Patient Relations call center
- answers provider calls regarding enrollee eligibility or claims status enquiries
- actively supports enrollment and eligibility processing functions and enrollee materials distribution
- answers incoming contacts to the call center to meet contractual and regulatory requirements for call center operations that support Medicare and California Medi-Cal managed care plans
- participates in the Member Services Department's processes to meet enrollment and disenrollment timeliness; complaint, grievance and appeal intake documentation and acknowledgement; and enrollee non-emergency transportation booking rules
- contributing to Member Services operation so it complies with Centers for Medicare and Medicaid Services (CMS) and California Department of Health Care Services, regulations, yet delivers thorough service to enrollees and providers in a professional, competent and compassionate manner.
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What This Job Offers
Career Level
Entry Level
Industry
Religious, Grantmaking, Civic, Professional, and Similar Organizations
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees
