| Member Services Representative, Sr. Job Description |
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| The following is a full job description for Member Services Representative, Sr.. Here are the requirements and responsibilities for Member Services Representative, Sr. along with statistics. If after reading this page you determine that Member Services Representative, Sr. is not the position you are looking for, you may want to try one of these similar titles: Member Services Director, Member Services Representative, Member Services Manager, Member Experience Specialist, Membership Services Representative II, Membership Services Representative I, Member Services Supervisor, Member Education Coordinator, Professional Services Manager |
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| Requirements and Responsibilities For Member Services Representative, Sr. |
| Responsible for providing customer service to healthcare plan members. Explains coverage details, confirms eligibility, verifies claim status, and may resolve billing issues. Directs patients to in-network doctors and explains the authorization process for specialized care. Researches issues and escalates as appropriate. Maintains confidentiality per HIPAA guidelines. Requires a high school diploma or equivalent. Typically reports to a supervisor. Works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. Typically requires 3-5 years of related experience. |
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| Also referred to as: Health Plan Member Services Senior Representative, Health Plan Member Support Senior Representative, Member Services Representative II |
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| Similar Jobs: Member Services Director, Member Services Representative, Member Services Manager, Member Experience Specialist, Membership Services Representative II, Membership Services Representative I, Member Services Supervisor, Member Education Coordinator, Professional Services Manager |
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| Level of Education: Member Services Representative, Sr. Salaries with a High School Diploma or Technical Certificate, Member Services Representative, Sr. Salaries with an Associate's Degree, Member Services Representative, Sr. Salaries with a Bachelor's Degree, Member Services Representative, Sr. Salaries with a Master's Degree or MBA, Member Services Representative, Sr. Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Edu., Gov't. & Nonprofit, Healthcare, Insurance | |
