Member Service Representative

Are you an experienced Customer Service Representative looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

Daily Responsibilities:

• Receive and respond to all telephone inquiries from members or providers

• Research and provide information regarding member's eligibility, benefits, referrals and authorizations

• Provide members with information on the Provider Network and how to contact and access providers

• Educate providers on prior authorization requirements, how to access services and other routine, non-clinical issues

• Educate providers on process of submitting outpatient treatment requests for outpatient therapy

• Initiate or fax necessary forms to providers for outpatient therapy services

• Coordinate with Provider Relations regarding contracting and/or credentialing status

• Document all members' issues and resolution in the computer systems

• Provide backup support to Data Entry team as necessary

Shift: Monday-Friday

• 2-3 weeks of training: 8am-5pm

• After training, shift would range from 10am-7pm

• High school diploma or equivalent

• 2+ years of related experience with at least 1 year customer service experience in a call center environment, preferably in a Medicare, Medicaid managed care or insurance environment

• Experience with Microsoft Excel, Word and Access applications preferred

• Spanish and English preferred

Interested in being considered?

If you are interested in applying to this position, please contact (Sheena Lagaylay, 407-965-2843) and click the Green I’m Interested Button to email your resume.

Please click APPLY for immediate consideration.