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Job

Member Services Representative

Posted by
UNITE HERE HEALTH
|
Atlantic City, NJ
New
|
Published 13 days ago

The purpose of this position is to be the face of the fund, especially to members and to provide benefit, eligibility, claim and health care education, information and issue resolution to a multi-cultural community. The Member Services Representative shares the UNITE HERE HEALTH message by encouraging the utilization of benefits according to plan benefits and best healthcare value, while optimizing the member’s service experience.

 ESSENTIAL JOB FUNCTIONS AND DUTIES

  • Serves as the main point of contact for the Fund’s members, unions, employers, providers, and vendors on benefit, claims and eligibility issues, education and questions
  • Receives and records telephone and walk-in inquiries regarding plan benefits, claims and eligibility
  • Performs enrollment functions, including telephonic and in-person outreach
  • Encourages members to take steps to get involved in programs to improve their health Recognizes and communicates issues to management including trends and anomalies
  • Researches benefit, eligibility and claim issues and initiates corrective action with relevant departments
  • Maintains up-to-date knowledge of all systems and sources relating to plan benefits, processes, policies, etc. that will affect performance of daily tasks
  • Assists in member outreach, including telephonic and face to face in the Fund office, union office and worksites
  • Seeks management assistance on issues unable to resolve in a timely manner
  • Participates in benefit presentations
  • Assists in daily office operations
  • Sets goals and achieve measurable results
  • Contributes ideas to plans and achieving department goals
  • Performs other duties as assigned within the scope of responsibilities and requirements of the job
  • Performs Essential Job Functions and Duties with or without reasonable accommodation

ESSENTIAL QUALIFICATIONS

 Years of Experience and Knowledge

  • 0 ~ 2 years of direct experience minimum in healthcare, insurance, Union or community engagement environment
  • Experience with multi-cultural communities
  • Working knowledge and experience in customer service duties in person and/or over the phone
  • Experience in call center preferred

 Education, Licenses, and Certifications

  • Associate's degree in Healthcare or related field or equivalent work experience required

 Skills and Abilities

  • Intermediate level Microsoft Office skills (Word, Outlook)
  • Beginner level Microsoft Excel skills
  • Intermediate level system(s) skills in computer and keyboarding
  • Required fluency (speak and write) in Spanish, Cantonese or Tagalog
  • Listening and communication skills (written and verbal)
  • Customer service and relationship building skills
  • Team, research and problem solving skills
  • 10% ~ 15% travel
  • Ability to connect with others on a personal level


The purpose of this position is to be the face of the fund, especially to members and to provide benefit, eligibility, claim and health care education, information and issue resolution to a multi-cultural community. The Member Services…

Details at a Glance

  • Time Commitment
    Full Time Schedule
  • Education
    2-Year Degree Required
  • Professional Level
    Entry level

Benefits

Medical/Dental/Vision

Pension

401k

ST/LT Disability

Paid Time Off

Up to 12 Paid Holidays

FSA

Tuition Reimbursement

Medical/Dental/Vision

Pension

401k

ST/LT Disability

Paid Time Off

Up to 12 Paid Holidays

FSA

Tuition Reimbursement

Level of Language Proficiency

Spanish,

Cantonese or,

Tagalog

Spanish,

Cantonese or,

Tagalog

Location

Temporarily Remote
Work must be performed in or near Atlantic City, NJ
Associated Location
1801 Atlantic Ave, Atlantic City, NJ 08401, USA
Suite 200

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