Member Service Representative (Troy, MI)
Summary – Responds to incoming telephone calls pertaining to the funds they are trained in from members and providers.
Essential Duties and Responsibilities include but not limited to
- Communicates with customers face to face, electronically or via telephone
- Assist callers with questions regarding: deductibles, out of pocket accumulators, dental benefits, vision benefits, MRA or Benny Card, Vacation, or SUB Pay
- Formulate resolution and respond to inquiries in a timely and accurate manner
- Follow-up with customers to ensure that their issues are sufficiently resolved
- Make outgoing calls to members, provider’s, collection agency, and vendors, such as Cofinity and Blue Cross & Blue Shield
- Maintain records of all interactions with the members/providers
- Thoroughly explain group benefits to participants
- Status claims when necessary
- Request check tracers, refunds and reissue checks
- Create task inquiry and follow through after the inquiry has been logged into the system
- Mail reimbursement forms and other correspondence to members
- Complete precertification’s for members
- Complete HDM reports
- Coordinate phone coverage with coworkers if they are leaving their desk for short periods of time
- Assisting with claims/eligibility issues
- Regular and predictable attendance is an essential function of this job
Supervisory Responsibilities – None
Qualifications - Must be able to exhibit compassion and patience for the members who need a little extra time to express themselves. Must have good conflict training, analytical skills, problem solving skills and organizational skills.
Education and/or Experience – Post High School education or prior related work experience.
Language Skills – Ability to read and interpret; the plan rules as outlined in the SPD’s, user manuals for on-line services, department rules and procedures manual and COBRA Compliance manual. Must be able to speak clearly and effectively and to explain to members, dependents, providers and union officials the rules of the plan. Must have superior written and verbal communication skills.
Mathematical Skills - Ability to apply concepts of basic addition, subtraction, multiplication and division.
Reasoning Ability - Representative must be analytical. Representative must be able to deal with people in stressful situations. Superior communication skills and keen observation is essential. Careful attention to what a caller is asking for and then using good judgment. Ability to apply common sense to carry out detailed written or oral instructions. Ability to deduce if a balance due is the responsibility of the Member or if the plan has yet to consider the charges.
Certificates, Licenses, Registrations - None required.
Physical Demands - Occasional lifting of paperwork and printer paper.
Work Environment - Noisy, pressured, stressful. Fast paced department. Phone calls are continuous and often unpleasant. Must be able to maintain composure with difficult callers, work independently as well as in a team, must be able to multi-task and be detail oriented. Confident to handle difficult situations. Quick and accurate typing skills. Able to deal with customers with diverse backgrounds. Willing to tackle any relevant customer service training. Must be able to have knowledge of and handle multiple group benefits. Must be able to work independently and in a team. Must be flexible and willing to pitch in and work together as a team member and must be willing to help other departments within the company. Must assist members and clients professionally and to the best of his/her ability. Some knowledge of claims processing.
Work Schedule
Full time. Monday - Friday, 7:30am - 4:30pm. Required in office (no at-home days).
Competitive Benefits & Compensation Package
- 15 days Paid Time Off (PTO) during first full calendar-year of service
- 12 paid holidays
- 3 days paid bereavement
- Up to 20 days paid jury leave
- Medical, dental, and vision insurance, with option for dependent coverage
- Company-paid basic life, short-term disability, long-term disability, and AD&D insurance
- 401k with employer match
- Tuition reimbursement program
- Career development opportunities
- Referral bonus for all successful full-time referrals
- Annual opportunities for increases and bonuses
Pay
Hourly rate ranges from $18.00 - $20.00. Actual rate dependent on location, skills, education, experience and other business factors.
Our Culture
BeneSys wants to be a great service provider to the members we serve, and we recognize we can only do that if we are also a great employer with successful employees. In short, our success is driven by our employees successes. We want to be a place where people want to work, feel proud of what they do and feel fulfilled both professionally and personally. We want to create a place where employees can find long-term growth and potential.
Our culture focuses on three core values:
- Collaboration: working together across 31 locations to achieve the best for the company and our clients
- Dedication: striving to create an environment where all employees work toward a common goal while committing to providing the best customer service to our members and our colleagues
- Integrity: doing what we say we will do. Upholding strong ethical and moral principles
ADA & EEO
Reasonable accommodations will be made so that qualified individuals with disabilities are able to complete the application process and, if hired, fulfill the essential functions of their job.
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