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8May

Member Services Representative

Medical Associates, Dubuque, IA

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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. 

Role:
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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Job Details

Req Num 18-0069
ID 511428
Location
Dubuque, IA
Positions 1
Type
Employee
Status
Full Time
Pay --
Categories
Health Care
Shifts
First Shift
Benefits
Health Insurance
Dental Insurance
Life Insurance
Retirement Plan
Paid Vacation
Paid Sick Leave
Paid Holidays

Preferred Candidates

Years of Experience 1-2 Years
Education High School/GED

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