Member Services Representative

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

📋 Description

• Organize appointments and assist members in scheduling visits with primary care providers.

• Collect medical histories and maintain updated information for both members and providers.

• Acquire and handle medical records from various providers.

• Collaborate with vendors to coordinate the collection of charts.

• Make outbound calls to provider groups for the purpose of requesting medical records.

• Retrieve charts from electronic medical record systems.

• Assemble medical records for coding teams.

• Fulfill supplemental medical records requests utilizing Excel files.

• Provide vendors with updated member and provider information.

• Direct medical record requests to the appropriate parties.

• Address outstanding vendor issues by updating demographics and managing chart load challenges.

• Follow up on member appointments and assigned tasks.

• Support with various ad hoc requests.

⛳️ Requirements

• Strong customer service skills for phone outreach to provider groups.

• A minimum productivity target of 30 pends every 10 days, including at least 30 calls daily.

• Familiarity or capability to utilize electronic medical record systems.

• Proficiency in completing supplemental medical records requests using Excel files.

• Competence in updating member and provider demographic information.

• Ability to collaborate with vendors on chart collection and resolve chart load challenges.

• Timely resolution of outstanding vendor pends is essential.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Critical Illness, Accident, and Hospital insurance.

• 401(k) Retirement Plan with options for Pre-tax and Roth post-tax contributions.

• Life Insurance options including Voluntary Life & AD&D for employees and their dependents.

• Short-term and long-term disability coverage.

• Health Spending Account (HSA).

• Transportation benefits available.

• Employee Assistance Program provided.

• Paid Time Off/Leave (PTO, Vacation or Sick Leave).