Member Services Supervisor supervises a group of member services representatives that address 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 researching more complex questions, investigating the cause of the issue, and responding to members on escalated issues. Being a Member Services Supervisor assists with hiring, training, ongoing monitoring and QA, performance evaluations and any corrective actions of member services representatives. Requires a high school diploma or its equivalent. Additionally, Member Services Supervisor typically reports to a manager. The Member Services Supervisor supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes and procedures. Thorough knowledge of functional area under supervision. To be a Member Services Supervisor typically requires 3 years experience in the related area as an individual contributor. (Copyright 2024 Salary.com)
POSITION SUMMARY:
The Customer Services Representative (CSR) always presents a positive image to Florida Health Care Plans members. This position requires proficiency in answering calls, responding to emails, online chat, and in person support for FHCP members related to inquiries, complaints, grievances, & appeals. Must be accurate and efficient in researching benefits and assisting members in understanding their plan. The CSR must be timely and proficient in documenting all communication with members.
QUALIFICATIONS:
Education, Skills, and Experience: