| Member Services Representative Job Description |
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| The following is a full job description for Member Services Representative. Here are the requirements and responsibilities for Member Services Representative along with statistics. If after reading this page you determine that Member Services Representative is not the position you are looking for, you may want to try one of these similar titles: Member Services Representative, Sr., Member Services Manager, Member Services Director, Member Services Supervisor, Member Experience Specialist, Membership Services Representative II, Membership Services Representative I, Member Education Coordinator, Account Services Representative |
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| Requirements and Responsibilities For Member Services Representative |
| Addresses member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for receiving, responding to, and directing member phone calls, or written questions. Provides available information upon request and researches or escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines. Requires a high school diploma or equivalent. Typically reports to a supervisor or manager. Works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. Typically requires 1-3 years of related experience. |
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| Also referred to as: Health Plan Member Services Representative, Health Plan Member Support Representative |
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| Similar Jobs: Member Services Representative, Sr., Member Services Manager, Member Services Director, Member Services Supervisor, Member Experience Specialist, Membership Services Representative II, Membership Services Representative I, Member Education Coordinator, Account Services Representative |
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| Level of Education: Member Services Representative Salaries with a High School Diploma or Technical Certificate, Member Services Representative Salaries with an Associate's Degree, Member Services Representative Salaries with a Bachelor's Degree, Member Services Representative Salaries with a Master's Degree or MBA, Member Services Representative Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Edu., Gov't. & Nonprofit, Healthcare, Insurance | |
