Member Service Representative (Troy, MI)

Member Service Representative (Troy, MI) Summary Responds to incoming telephone calls pertaining to the funds they are trained in from members and providers.

Each representative will be required to answer approximately 80-100 calls per day.

Member Service Representative Responsibilities: Communicates with customers face to face, electronically or via telephone.

Assist callers with questions regarding deductibles, out of pocket accumulators, dental benefits, vision benefits, MRA or Benny Card, Vacation, or SUB Pay.

Exhibit compassion and patience for the members who need a little extra time to express themselves.

Confident to handle difficult situations.

Formulate resolution and respond to inquiries in a timely and accurate manner.

Follow-up with customers to ensure that their issues are sufficiently resolved.

Make outgoing calls to members, provider’s, collection agency, and vendors, such as Confinity and Blue Cross & Blue Shield.

Maintain records of all interactions with the members/providers.

Explain and understand group benefits clearly.

Good conflict training, analytical skills, problem solving skills and organizational skills.

Quick and accurate typing skills.

Able to deal with customers with diverse backgrounds.

Willing to tackle any relevant customer service training Knowledge of claims processing and able to status claims.

Request check tracers, refunds, and reissue checks.

Knowledge of claims processing and able to status claims.

Create task inquiry and follow through after the inquiry has been logged into the system.

Assist callers with Vacation information Assist callers with SUB Pay information Mail reimbursement forms and other correspondence to members.

Complete precertification’s for members.

Complete HDM reports.

Coordinate phone coverage with coworkers if they are leaving their desk for short periods of time.

Assisting with claims/eligibility issues.

Assist members and clients professionally Read and interpret the plan rules as outlined in the SPD’s, user manuals for on-line services, department rules and procedures manual and COBRA Compliance manual Be able to clearly explain deductibles, out of pocket accumulators, medical, dental and vision benefits.

Call transferring is expected to be minimal, and a call will be transferred only if the caller is requesting assistance for an area the representative is not trained in, i.e., Pension.

Difficult claims will be transferred to supervisor for handling.

Make sure there is adequate phone coverage with coworkers if they are leaving their desk for any reason.

Apply common sense to carry out detailed written or oral instructions Deduce if a balance due is the responsibility of the Member or if the plan has yet to consider the charges Explain to members, dependents, providers, and union officials the rules of the plan Member Service Representative Qualifications: Post high school education or prior related work experience Ability to read and interpret; the plan rules as outlined in the SPD’s, user manuals for on-line services, department rules and procedures manual and COBRA Compliance manual.

Must be able to speak clearly and effectively and to explain to members, dependents, providers, and union officials the rules of the plan.

Ability to apply concepts of basic addition, subtraction, multiplication, and division.

Representative must be analytical.

Representative must be able to deal with people in stressful situations.

Superior communication skills and keen observation is essential.

Careful attention to what a caller is asking for and then using good judgment.

Ability to apply common sense to carry out detailed written or oral instructions.

Ability to deduce if a balance due is the responsibility of the Member or if the plan has yet to consider the charges.

Must be able to have knowledge of and handle multiple group benefits.

Must be able to work independently and in a team.

Must be flexible and willing to pitch in and work together as a team member and must be willing to help other departments within the company.

Quick and accurate typing skills Able to work with customers with diverse backgrounds Willingness to tackle any relevant customer service training Some knowledge of claims processing Member Service Representative Work Schedule Full time, Monday – Friday 7:30am
– 4:30pm.

Competitive Benefits & Compensation Package Paid Time Off (PTO) 15 days of PTO during the next calendar year Medical, dental, vision, and life insurance Company paid short term disability, long term disability, and AD&D insurance 401k with employer match Tuition reimbursement program Paid training Career development opportunities Referral bonus for all full-time referrals Competitive wages Annual opportunities for increases and bonuses Pay Pay commensurate with education and experience.

COVID-19 Considerations Masks are required by all employees and clients Daily sanitation procedures in place Daily check-in program with rigorous contact tracing Our Culture BeneSys wants to be a great service provider to the members we serve, and we recognize we can only do that if we are also a great employer with successful employees.

In short, our success is driven by our employees’ successes.

We want to be a place people want to work, feel proud of what they do and feel fulfilled both professionally and personally; creating a place where employees can find long-term growth and potential.

Our culture focuses on three core values: Collaboration: working together across 31 locations to achieve the best for the company and our clients.

Dedication: striving to create an environment where all employees work toward a common goal while committing to providing the best customer service to our members and our colleagues.

Integrity: doing what we say we will do.

Upholding strong ethical and moral principles ADA & EEO PM21