The Member Services Representative (MSR) is the primary contact for members and providers interacting with internal departments or external entities, such as Medical Groups, Health Care Providers, and Brokers.

Responsibilities:

- Accurately record and refer appeals and grievances in line with department protocols and procedures.

- Educate members about the Referral Program, company website, and online self-service tools.

- Assist members, providers, brokers, and plan partners with claims-related billing questions and issues.

- Collaborate with inter- and intra-department staff to resolve member issues within prescribed timeframes.

- Manage challenging or emotional customer situations, respond promptly to customer needs, solicit feedback for service improvement, respond to service requests, and fulfill commitments.

- Report any system problems or urgent call drivers to the Member Service Supervisor or Manager immediately.

- Interact with clients, the public, and others with tact, discretion, and courtesy.

Qualifications:

- High School Diploma.

- Minimum of 2 years of experience working in a call center.

- At least 1 year of experience in the healthcare industry, specifically with HMO, is a plus.

- Basic computer skills, including email, databases, word processing, spreadsheets, and graphics.

- Bilingual abilities are a plus!

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records subject to federal contractor requirements and/or security clearance requirements.