Member Services Representative, Sr. addresses more complex health plan or HMO member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for receiving, responding to, and directing member phone calls and written requests. Being a Member Services Representative, Sr. provides available information upon request and researches or escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines. Additionally, Member Services Representative, Sr. requires a high school diploma or equivalent. Typically reports to a supervisor or manager. The Member Services Representative, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Member Services Representative, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)
Employees at a franchise location are employed by the Franchisee and are not employees of PFHQ (the Franchisor). PFHQ neither dictates nor controls labor or employment matters for franchisees or their employees, and does not retain any reserved authority to control the terms and conditions of employment for franchisees or their employees. Each franchisee is responsible for ensuring compliance with local, state and federal law.
Clear All
0 Member Services Representative, Sr. jobs found in Allentown, PA area