Member Service Representative

• Provide efficient, courteous, professional service to members, providers, group administrators, brokers, Plan personnel, and the general public
• Respond to inquiries received by telephone, fax, written correspondence, email, internet messenger, and personal interviews
• Address enrollment, billing, benefits, and claims inquiries for various coverage types
• Research and analyze customer inquiries using policies, procedures, PC systems, manuals, and Image
• Resolve routine and moderately complex benefits, claims, billing, enrollment, COBRA, Medicare Secondary Payor, and related issues
• Provide clear instructions to appropriate Plan areas for issue resolution
• Contact internal and external entities to obtain information and initiate necessary action
• Respond verbally or in writing with accurate and timely information
• Monitor inquiries for timely and accurate resolution and customer satisfaction
• Update Facets or Inquiry Control System records to track inquiry actions and status
• Report inquiry trends to management
• Support Marketing personnel and brokers by researching and communicating customer information
• Participate in marketing activities such as health fairs, seminars, open enrollment, and on-site visits