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18Sep

Member Services Representative

Medical Associates, Dubuque, IA

This listing has expired

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. 

The Position:

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.

This listing has expired

Job Details

ID 757983
Location
Dubuque, IA
Positions 1
Type
Employee
Status
Full Time
Pay --
Categories
Customer Service
Health Care
EMSI Skills Appeals
Communications
Customer Service
Microsoft Office
Research
Benefits
Health Insurance
Dental Insurance
Life Insurance
Retirement Plan
Paid Vacation
Paid Sick Leave
Paid Holidays

Preferred Candidates

Years of Experience --
Education High School/GED

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