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Member Services Representative (12PM-9PM Shift)

Location:Sacramento, CA
Salary Range:DOE
Exempt/Non-Exempt:Non-Exempt
Benefits:We provide a comprehensive benefit package that represents a generous part of the employees’ total compensation. Our benefits include medical, dental, vision, 401k, Discretionary Profit Sharing, Life Insurance, Employee Assistance program, and much more.
Employment Type:Full Time
Description:Under the direction of the member services supervisor, an MSR must demonstrate professionalism, efficiency, courtesy, and compassion—provide exceptional service—in maintaining customer relationships.
Duties:MAJOR RESPONSIBILITIES
• develop and maintain rapport with American Health Care customers, clients, and pharmacies
• enter prior authorizations based on plan design
• fulfill back-up duties for receptionist
• maintain the request for prior authorizations (all needed information)
• answer inquiries regarding member eligibility, claim processing, benefit coverage
• resolve non-standard complaints with some guidance
• develop and maintain productive relationships with peers and other department staff
• have full understanding of customer service philosophy and procedures of the company
Qualifications:SKILL SET:

• knowledge of MS Word and Excel
• ability to use tact and diplomacy in dealing with people, both internal and external
• calm demeanor while completing multiple tasks
• eagerness to embrace changes in responsibilities and procedures
• ability to work independently and as a team member
• excellent telephone skills
• knowledge of HIPAA requirements
• positive “can-do” attitude when faced with customer concerns
• typing speed of at least 30wpm
• bright, articulate, and capable of demonstrating exceptional customer service

REQUIREMENTS:

• high school diploma or equivalent
• two years call-center experience—please do not apply if you do not have call-center experience
• pharmacy experience (preferred, but not required)
• completion of medical terminology course (preferred, but not required)
• pharmacy technician certification (preferred, but not required)


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