Member Services Agent

This is a fully remote position, open to applicants in Louisiana.

📋 Description

• Deliver exceptional customer service to both internal and external clients.

• Utilize comprehensive knowledge of company products and programs to assist customers effectively.

• Communicate with customers via telephone regarding the processing of Rx claims.

• Maintain thorough records of customer interactions and transactions.

• Follow up to ensure that necessary changes address customer issues.

• Refer unresolved customer complaints to the appropriate departments.

• Review Rx insurance policy terms to ascertain claim coverage for employer groups.

• Reach out to customers regarding inquiries, results of claim investigations, or upcoming adjustments.

• Address customer service and billing complaints efficiently.

• Analyze relevant information to evaluate the validity and causes of complaints.

• Safeguard and report issues that involve HIPAA-protected health information.

• Attend and demonstrate proficiency in mandatory HIPAA training.

• Carry out additional assigned responsibilities as business needs evolve.

⛳️ Requirements

• High School diploma or equivalent.

• Experience in customer service.

• Proficiency in computer usage.

• Understanding of principles and processes for delivering customer and personal services.

• Capability to use computers and related systems effectively.

• Ability to communicate with supervisors, colleagues, subordinates, customers, and external parties via telephone, email, written communication, or in person.

• Competence to obtain, process, calculate, audit, and verify information and data.

• Skill in managing complaints, resolving disputes, and addressing grievances.

• Organizational skills with the ability to plan, prioritize, and manage time effectively.

• Experience in performing administrative tasks and maintaining information files.

• Strong problem-solving and analytical abilities.

• Proficient communication skills.

• Team-oriented mindset.

• Technical aptitude.

• Ability to multitask.

• Flexibility to work assigned shifts, including call center operating hours.

• Availability for rotating on-call duties.

• Commitment to comply with HIPAA regulations and complete necessary HIPAA training.

🏝️ Benefits

• Equal employment opportunity with nondiscrimination protections.

• HIPAA training offered by the company.