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.
This is a full-time position working in the Member Services department at Medical Associates Health Plans. Candidates must be available to work Monday through Friday between the hours of 8:00am and 5:00pm.
Provide superior customer services to all Medical Associates Health Plan (MAHP) members, potential members, provider office personnel, along with Medical Associates Clinic and Health Plans staff.
Essential Functions & Responsibilities:
Respond to phone, in-person, written or e-mail inquiries from members, group contacts, brokers, providers, pharmacies as well as internal customers, in accordance with department standards. Perform research on inquiries and resolve; educate members on benefits, interpreting their Explanation of Benefit forms, the use of the website and other MAHP tools and documents.
Possess knowledge and ability to communicate to internal and external customers regarding benefit plans, including medical, prescription drug and Health Reimbursement Arrangement (HRA) Accounts.
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 pay 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
|Years of Experience||1-2 Years|