| Member Services Manager Job Description |
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| The following is a full job description for Member Services Manager. Here are the requirements and responsibilities for Member Services Manager along with statistics. If after reading this page you determine that Member Services Manager is not the position you are looking for, you may want to try one of these similar titles: Professional Services Manager, Member Services Director, Professional Services Senior Manager, Member Certification Manager, Member Services Supervisor, Member Education Manager, Member Experience Specialist, Member Education Coordinator, Member Services Representative |
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| Requirements and Responsibilities For Member Services Manager |
| Manages the team responsible for providing customer service to healthcare plan members. Explains coverage details, confirms eligibility, verifies claim status, and may resolve billing issues. Ensures member service representatives follow established policies for addressing member inquiries and meet service quality goals. Responsible for researching more complex questions, investigating the cause of the issue, and responding to members on escalated issues. Maintains confidentiality per HIPAA guidelines. Requires a bachelor's degree. Typically reports to a director. Manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes. |
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| Also referred to as: Health Plan Member Services Manager |
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| Similar Jobs: Professional Services Manager, Member Services Director, Professional Services Senior Manager, Member Certification Manager, Member Services Supervisor, Member Education Manager, Member Experience Specialist, Member Education Coordinator, Member Services Representative |
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| Level of Education: Member Services Manager Salaries with a Bachelor's Degree, Member Services Manager Salaries with a Master's Degree or MBA, Member Services Manager Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Edu., Gov't. & Nonprofit, Healthcare, Insurance | |
