Member Services Representative

Medical Associates • Dubuque, IA

252d • Remote

About The Position

If you are looking for a customer service based position that has a variety of clerical duties, offers a flexible schedule, and the opportunity to work from home if desired, your search is over! Medical Associates Health Plans is looking for a full-time Member Services Representative to join our team!

Requirements

• One to three years of similar or related experience.
• High school diploma or GED required.
• Excellent telephone presence.
• Familiar with Microsoft Office applications, particularly Word and Excel.

Responsibilities

• Respond to phone, in-person, written or e-mail inquiries from members, employers, brokers, providers, pharmacies as well as internal customers, in accordance with department standards.
• Perform research on inquiries and resolve; educate members on benefits, Explanation of Benefit forms, the use of the website and other tools and documents utilized by members.
• Possess knowledge and ability to communicate to internal and external customers regarding benefit plans, including medical, prescription drug and other employee benefit plans offered.
• Interpret and enter necessary data and documentation into member and authorization subsystems of core business processing system as necessary to support the member services department; possess knowledge to examine, process, calculate and administer claims according to internal processing guidelines.
• Assist in review and resolution of complaints, appeals and grievances as needed.
• Complete all additional assigned projects and duties.

Benefits

• Single or Family Health Insurance with discounted premium rates for wellness program participation.
• 401k with immediate matching (50% on the dollar up to 7% of pay + additional annual Profit Sharing)
• Flexible Paid Time Off Program (24 days off/year)
• Medical and Dependent Care Flex Spending Accounts
• Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED