Job description

A competative medical center local to the doral area is searching for an experienced medical Member Services Representative.

Position Title: Member Services Representative

Hours of Operation: 8:00AM - 8:00PM (Any 8-Hour Shift Assigned)

Schedule: Monday - Saturday (Rotating Saturdays)

Top Keys:

• 1+ Years experience working with Medicare or Medicare health insurance
• 1+ Years experience in medical billing & insurance
• Bilingual - English & Spanish

Responsibilities:

• Professionally handles a high volume of complex calls and may also process correspondence (mail, faxes, or written letters).
• Research accounts, claim history or benefits to identify issues and resolution steps.
• Able to explain to the caller any action that is required to resolve the inquiry or concern.
• Identifies complaints (grievances), requests for coverage determinations or appeals, and possible fraud, waste, or abuse to forward to the correct department for research and resolution.
• Contributes to meeting or exceeding CMS call center metrics and Call center goals.
• Follows up with caller to provide response or resolution steps as needed.
• Clearly documents incoming and outgoing call reasons and dispositions in the call center system
• Participates in training and in-service education as required.
• Participates in department, clinic and other meetings as requested.

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Job Type: Full-time

Pay: $17.00 - $19.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Shift:

• 8 hour shift

Weekly day range:

• Monday to Friday
• Rotating weekends
• Weekend availability

Ability to commute/relocate:

• Doral, FL: Reliably commute or planning to relocate before starting work (Required)

Education:

• High school or equivalent (Required)

Experience:

• Medicare: 1 year (Required)
• Medical Billing: 1 year (Required)

Language:

• English (Required)
• Spanish (Required)

Work Location: One location

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