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Membership Services Servicing Associate II - Regular On Contract


Posted: 10/2/2019
Job Status: Contract/Temporary
Job Reference #: 5000487794206

Job Description

Employment Type

Full Time - Regular-On-Contract

Exempt or Non-Exempt


Job Summary

***(ROC) Regular-on-Contract Two Years from Date of Hire***

To provide an optimal Customer Experience by insuring Quality Care and Affordability. Identify and proactively resolve enrollment, eligibility, billing issues to prevent adverse customer impacts and inquiries from members and employer groups. Ensure that all government, Association and HMSA guidelines, objectives and performance standards are met. Perform quality assurance validation and provide recommendations to improve customer satisfaction.

Minimum Qualifications

  1. Associate's degree and one year of related work experience or equivalent combination of education and experience.
  2. Strong customer servicing skills.
  3. Strong data entry skills.
  4. Strong organization skills.
  5. Strong decision-making and problem analysis skills.
  6. Demonstrated ability to work independently with minimal supervision.
  7. Demonstrated ability to multitask, managing time and priorities appropriately.
  8. Demonstrated ability to perform detail-oriented work.
  9. Strong written and verbal communication skills.
  10. Skilled in using Microsoft Office software, including Word and Excel.

Duties and Responsibilities

  1. Proactively resolve enrollment, eligibility and billing issues and inquiries timely and accurately from members, employer groups and third party administrators by phone, email, in person and written correspondence by:
    • Researching and collaborating with other units or departments to find a solution or prevent adverse customer outcomes
    • Accurately updating member records
    • Contacting external partners who provide services for/to HMSA's members
    • Providing member or group education on enrollment, billing (bill resentment) and bill payment
  2. Perform daily enrollment functions to include processing of enrollments, disenrollment and maintenance for members.
  3. Research and resolve enrollment and billing reconciliation activities for purpose of identifying discrepancies and initiating accurate and timely correction/resolution of internal as well as external processing systems
  4. Perform quality assurance validation of customer inquiries and member updates within constrained timeframes. Based on patterns or risk assessment, recommend improvement opportunities to provide processing efficiency and increase customer satisfaction. These can include but are not limited to identifying processing or servicing issues that can be addressed by a system or a workflow solution.
  5. Training and development.
  6. Perform other duties as assigned.