To create an exceptional experience for our members, providers, and internal/external customers while assisting them with inquiries, issues and concerns that are presented. With the objective of providing quality and consistent service to Medicare and Medicaid members resulting in increased member satisfaction, retention and access to care.
Scope of Position
Responsible for handling all incoming telephone calls, emails, correspondence and internal contacts regarding benefits, supplemental benefits such as transportation request, claim status, primary care physician changes, enrollment/eligibility, claims, grievances and appeals in accordance with the departmental goals, inclusive of appropriate documentation, policies and procedures established by Peoples Health. The Member Services Representative will perform some general administrative duties such as, but not limited to, covering the front desk functions, handling the mail, and faxing documents. Participate in and contribute to special projects as needed and all other duties as assigned.