Member Services Representative I Temporary - Bilingual English/Spanish preferred

Profile

We have an opportunity to join the Alliance as a Temporary Member Services Representative (MSR) (English/Spanish Bilingual preferred) in the Member Services Department. You'll be working from home, Monday through Friday 8:30am to 5:30pm. This is a temporary assignment which will run from August 20, 2022 through through October 31, 2022. During the first three weeks of the assignment the training schedule is 8:00am - 5:00pm. We are going to onboard five MSRs in this upcoming cohort and due to the rigorous training schedule, you must be fully available during the training period to ensure that everyone in the cohort is able to keep up with training. You must have a private space to work from at home to ensure our members' privacy.
WHAT YOU'LL BE RESPONSIBLE FOR
Reporting to the Member Services Supervisor you will acts as the frontline customer service representative within the Member Services Department, providing assistance to members and providers. You will answer calls in a remote call center environment, and provide excellent customer service responding to and resolving routine customer inquiries and requests. You will provide information on how the health plan works, including providing information on benefits, provider network, accessing care, referrals, authorizations, claims and billing, coordination of benefits, and member rights and responsibilities. You will escalate issues to higher level staff, as needed.
WHAT YOU'LL NEED TO BE SUCCESSFUL
To read the full position description, and list of requirements click here
Knowledge of:
Bilingual (English/Spanish) preferred
Working knowledge of the principles and practices of customer service
General administrative procedures, standard business office practices and the operation of general office equipment, such as computer, fax and copier
Proper grammar, spelling, punctuation and formatting
Windows-based PC systems and Microsoft Word, Outlook and Excel, and database systems
The basic principles and practices of health care
Ability to:
Understand and communicate the complex operations and processes of the Alliance, particularly those related to Member Services and Care Management
Translate healthcare-related terminology and complex processes into simple language and step-by-step instructions when communicating with members and providers
Utilize a variety of computer systems, including the Alliance information system and external web sites and databases
Demonstrate strong organizational skills and attention to detail
Interpret, apply, and explain policies standards, regulatory requirements, and guidelines
Gather and evaluate information, ask appropriate questions, and utilize active listening and problem solving skills
Effectively, clearly and independently document, summarize and resolve member’s concerns and inquiries related to routine and moderately complex issues and recognize those issues requiring escalation to a higher level staff member
Education and Experience:
High school diploma or equivalent
Minimum of two years of customer service experience in member services, health care, public assistance or human services or three years of experience in a customer service or call center environment (an Associate’s degree may substitute for one year of the required experience); or an equivalent combination of education and experience may be qualifying
COVID-19 Vaccine Requirement:
At this time, this position requires vaccination or regular testing upon office entry. Fully vaccinated and boosted is defined as receipt of the second dose in a 2-dose series (ex: Pfizer & Moderna vaccines) OR receipt of a single-dose vaccine (ex: Johnson & Johnson); AND receipt of the booster (if eligible); AND a 2-week period having passed since the administration of the last vaccine dose. If you state that you are vaccinated, proof of vaccination must be submitted at time of hire.
Additionally, all positions at the Alliance are required to meet these minimum qualifications.
OUR BENEFITS
Medical, Dental and Vision Plans
Ample Paid Time Off
11 Paid Holidays per year
401(a) Retirement Plan
457 Deferred Compensation Plan
Robust Health and Wellness Program
EV Charging Stations
And many more
ABOUT US
We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.
Join us at **MEMBERS ONLY**SIGN UP NOW***. (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Merced, Monterey and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet
At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.

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