As the primary point of contact in our Call Center, the Member Services Specialist assists members telephonically with issues involving enrollment, transportation, benefit questions, coverage limits, payments, claims, and those matters that involve provider networks.
PERKS & BENEFITS:
Weekly Pay
Great environment
...
Temporary 3-6 month assignment that could go permanent
1st shift: 8:00 am - 4:30 pm, Monday-Friday
Responsibilities:
Assist members by telephone or in person, with questions, concerns, and complaints they may have regarding their enrollment with the services provided by company in order that
they receive satisfactory service and information.
Document all calls received in order that any audit, follow-up communication, grievances and appeals can be handled in an accurate, appropriate, and timely manner.
Assist Community Care Connectors (CCC) and other county staff with benefit questions, location of network providers, pharmacy issues, member materials, etc. in order that members are provided the best continuum of care possible.
Be aware of, or be able to obtain, Federal, State, and County laws and rules that regulate the provision of health care services to company members, including those that apply to enrollee Grievances and Appeals, in order and its employees are in compliance
with such laws and rules and that members suffer no loss of coverage.
Determine when an issue needs to be escalated to supervisor or other management personnel.
Initiate contact with new members to verify their receipt of new member materials and to inform them of the company's wellness programs, disease management services, and other services in order that members are fully aware of all services available to them.
Perform other duties as assigned within the scope, responsibility and requirements of the job.
Working hours: 8:00 AM - 4:30 PM
Skills:
Post high school education in business
Healthcare or insurance experience
Knowledge of Medicaid and Medicare rules.
Education:
High School
Experience:
1-4 years
Qualifications:
High school diploma or equivalent.
At least one year of practical experience in call center or customer service required.
APPLY TODAY!
Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Spherion, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact Callcenter@spherion.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Spherion offers a comprehensive benefits package, including health, and an incentive and recognition program (all benefits are based on eligibility).
For certain assignments, Covid-19 vaccination and/or testing may be required by Spherion's client or applicable federal mandate, subject to approved medical or religious accommodations. Carefully review the job posting for details on vaccine/testing requirements or ask your Spherion representative for more information.