Member Services Representative
Member Services Representative is responsible for providing customer service to healthcare plan members. Explains coverage details, confirms eligibility, verifies claim status, and may resolve billing issues. Being a Member Services Representative directs patients to in-network doctors and explains the authorization process for specialized care. Researches issues and escalates as appropriate. Additionally, Member Services Representative maintains confidentiality per HIPAA guidelines. Requires a high school diploma or equivalent. Typically reports to a supervisor. The Member Services Representative works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Member Services Representative typically requires 1-3 years of related experience.
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- Member Services Manager
- Member Services Director
- Member Services Supervisor
- Member Experience Specialist
- Member Education Coordinator
- Professional Services Manager
- Professional Services Director
- Member Services Representative, Sr.
- Membership Services Representative I
- Membership Services Representative II
- Member Services Representative Salaries with a High School Diploma or Technical Certificate
- Member Services Representative Salaries with an Associate's Degree
- Member Services Representative Salaries with a Bachelor's Degree
- Member Services Representative Salaries with a Master's Degree or MBA
- Member Services Representative Salaries with a JD, MD, PhD or Equivalent
