Member Services RepresentativeMedical Associates, Dubuque, IA
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Our mission is to provide superior healthcare and an excellent patient experience.
Medical Associates Clinic is a well-established multispecialty group practice with over 170 providers and a staff of over 1,000 health care professionals and support personnel. The group was founded in 1924 and is Iowa’s oldest multispecialty group practice. Today, Medical Associates Clinic is the area’s leading health care provider and only multispecialty group practice. Medical Associates Clinic has been recognized since 1998 as a “better performing practice” by the Medical Group Management Association.
In 1982, Medical Associates developed the Tri-State’s first health maintenance organization, Medical Associates Health Plans, which offers comprehensive health benefits to over 400 employers and 45,000 members. Medical Associates Health Plans has maintained an “Excellent” rating, the highest level of accreditation possible by the National Committee for Quality Assurance, for 13 consecutive years.
Medical Associates Clinic offers several locations from which to seek medical care, including facilities at 1500 Associates Drive, 1000 Langworthy, and 1940 Elm Street in Dubuque, Iowa; as well as facilities in Bellevue, Cascade, Dyersville, Elkader, and Monona, Iowa; Cuba City, and Platteville, Wisconsin; and Elizabeth and Galena, Illinois.
Medical Associates is looking for a Member Services Representative to join our team!
We have a full-time opening in the Member Services department at the Health Plans in Dubuque, IA. Mon-Fri 8:00-5:00.
Provide superior customer service to all Medical Associates Health Plan (MAHP) and Health Choices members, potential members, provider office personnel, employer groups along with Medical Associates Health Plans staff. Process and administer medical claims in compliance with state laws, employer contracts, policies and company procedures.
Essential Functions & 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.
Knowledge, Skills and Abilities:
Experience: One to three years of similar or related experience.
Education: Equivalent to a high school education.
Other Skills: Excellent telephone presence. Familiar with Microsoft Office applications, particularly Word and Excel.
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Paid Sick Leave
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