Member Services Representative
Member Service Representative
Who are we?
Versant Health is one of the nation’s leading administrators of managed vision care, serving millions of our clients’ members nationwide. We are driven by our mission to help members enjoy the wonders of sight through healthy eyes and vision.
As a Versant Health associate, you can enjoy a comprehensive Total Rewards package, which includes health and dental insurance, tuition reimbursement, 401(k) with company match, pet insurance, no-cost-to-you vision insurance for you and your qualified dependents. We are also invested in your success. There are many opportunities for advancement and development throughout all stages of your career with us.
See how you can make a difference with the support of strong leadership and a team environment.
See Everything, Be Anything™.
What are we looking for?
The Member Services Representative is responsible for receiving, answering, and/or resolving calls received through a Call Center. The Call Center receives phone calls from insured’s and their dependents, providers and their staff, employer/group staff, and brokers. The MSR will use companies Claims / Eligibility database to inquire on the status of claims, ID cards, addresses, and other issues as queried by the caller. The MSR is the primary source for issuing authorizations when eligible for services. In addition, the MSR performs duties consistent with customer/provider service.
Where you will have an impact
- Provide timely and accurate information to basic incoming customer calls from members, providers, and other external and internal constituents including:
- Issuing authorizations
- Handling claim inquiries from providers and members
- Communicate the correct information regarding accessibility, claims status and other calls of a service nature
- Providing benefits information
- Process customer claims according to established department policies and procedures
- Checking voicemail boxes and handling customer/provider requests for:
- I.D. cards
- Authorizations
- Customer Service questions and issues
- Fulfill rapid call volume by handling the appropriate amount of calls coming into the call center daily.
- Complete Provider Relations requests for service
- Provide timely feedback to the company regarding customer service failures and/or customer/provider concerns
- Partner with Sales and Provider Relations to meet and exceed customers’ expectations
- Provide excellent customer service and handle all customers in a professional and courteous manner
- Other duties as assigned
What’s necessary to do the job?
- High school graduate or equivalent is mandatory. Business related college courses preferred
- Two years customer service or call center experience
- Two years of experience in the health care industry or insurance environment preferred
- Strong computer and technical skills to support heavy key data entry
- Excellent customer service skills (friendly, courteous and helpful)
- Excellent interpersonal verbal and written communication skills
- The ability to diffuse volatile situations, share information, and educate callers regardless of customers level of understanding
- Understanding of the health insurance or insurance industries
- Strong execution and follow-up skills
- Goal oriented with ability to meet production standards
- Team orientation and ability to work effectively across functional areas of the company.
- Accurate and efficient data entry skills
- Strong analytical skill and ability to demonstrate good judgment
- Ability to coordinate multiple tasks and projects
- Skilled in dealing with all customers in an efficient and effective manner
- Bilingual skills helpful
HIPAA & Security Requirements
All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program.
Versant Health will never request money from candidates who seek employment with us and will never ask for any payment as part of the recruitment process.
Versant Health is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at Versant Health without regards to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.
The wage range for applicants for this position is [$19.00 to $21.00].
All incentives and benefits are subject to the applicable plan terms.
