Member Services Representative Job Description
Member Services Representative Duties & Responsibilities
To write an effective member services representative job description, begin by listing detailed duties, responsibilities and expectations. We have included member services representative job description templates that you can modify and use.
Sample responsibilities for this position include:
Member Services Representative Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Member Services Representative
List any licenses or certifications required by the position: CPR, AED
Education for Member Services Representative
Typically a job would require a certain level of education.
Employers hiring for the member services representative job most commonly would prefer for their future employee to have a relevant degree such as High School and Bachelor's Degree in Business, Finance, Financial Services, Education, Associates, Communications, English, Public Relations, Marketing, Communication
Skills for Member Services Representative
Desired skills for member services representative include:
Desired experience for member services representative includes:
Member Services Representative Examples
Member Services Representative Job Description
- Utilizes the company’s data/note repository systems and other resources to provide accurate information as requested from members, providers and other customers
- Provides “high quality customer service” in an efficient and professional manner at all times
- Takes ownership of each call by working to resolve issues efficiently and timely
- Implements and executes all processes, requests or policies as requested by management in a courteous and efficient manner
- Offers suggestions and recommendations and cooperates with all office associates and superiors effectively
- Responds to customer inquiries regarding Plan benefits and coverage explanations or issues regarding Care1st and AHCCCS/DDD/Medicare programs
- Sends Plan material, correspondence or special items to members as requested
- Enters complete and accurate documentation in the MHC and/or AWD system
- Processes all member issues, complaints/grievances within 24 hours of receipt
- Meets all performance objectives within the context of the position
- Completes all follow-up on member and provider issues in a timely manner
- Informs the Lead, Supervisor, Manager or Director of escalated issues, as appropriate
- Familiar with and adheres to PHI verification/HIPAA requirements
- Respects member confidentiality and privacy
- Uses proper phone etiquette and maintains a pleasant and professional tone throughout every call
- Maintains professional and appropriate behavior (actions/verbal) at all times
Member Services Representative Job Description
- Completes and passes all required testing
- Answer customer inquiries by clarifying desired information
- Resolve problems by clarifying customer requests
- Process all incoming fax and email
- Maintain thorough knowledge of all products and services to effectively cross-sell
- Cross-sell additional credit union products such as loans and suggest accounts (i.e., savings, checking, Money market)
- Support Members, Member Services Representatives, Sr
- Assist the Manager in carrying out special assignments and other duties as assigned
- Receive calls from members and providers
- Respond to customer's complaints and grievances
- Must possess excellent customer service skills along with strong conflict and problem resolution skills, time management and organizational skills
- Ability to effectively communicate verbally and in writing and work professionally and as a team member with all associates
- Ability to work in a diverse, demanding, and evolving environment
- Proven ability to multi-task (documentation of member records and accessing data across multiple systems while communicating with the caller)
- PC knowledge using MS Word and Excel or health care data system experience
- Strong adherence to schedule (breaks/lunch) to ensure service levels are achieved
Member Services Representative Job Description
- Recommend and cross-sell products and services to meet member needs
- Provide contract language interpretation and analysis
- Problem-solve for members in response to pay issues inquiries
- Provides data and other information as requested by intradepartmental teams including Disability, Legal, Compliance, Reporting
- Resolve escalated / complex customer issues by utilizing analytical and researching skills
- Utilize subject matter expertise to contribute to new business development initiatives and projects
- Other duties as assigned by the management team related to job functions (sort incoming faxes, correspondence, fax transportation forms)
- Assist members in balancing their accounts and research discrepancies
- Explain products and services to members
- Open new accounts and set-up new accounts and services
- The person should be capable with Outlook Internet software, Interactive Voice Response (IVR) Systems, Excel Spreadsheet software and Word Processing software
- National Technician Certification or State Technician License is a plus
- 3 years Previous banking/credit union experience preferred
- Obtaining any necessary missing information
- Must be bilingual (English/Spanish preferred)
- Excellent knowledge of Paramount health plan, member policies & procedures preferred
Member Services Representative Job Description
- Cross-sell Credit Union products and services
- Compile loan packet and prepare loan analysis for Loan Officers
- Work with Payroll Department to set up and end payroll deductions and direct deposits
- Order checks and assist members with debit card problems
- Set up and maintain payroll distributions in computer system
- Sell money orders and American Express products
- Responds to member inquiries over the phone, email and chat sessions by providing necessary information, direction and paperwork
- Conducts outgoing and follow up calls to address missed incoming calls
- Retrieves department emails and voice mail messages answering and resolving the interaction
- Connects members with the appropriate credit union representative when necessary
- Individual should have knowledge of database software used in claims payment and management
- Proven analytical mathematical skills
- Ability to work independently and as a positive team player
- Must be familiar with Microsoft Excel, Word, and Outlook and be willing to take assessments to prove abilities
- Demonstration of exceptional customer service
- MUST be fluent in Spanish or Polish
Member Services Representative Job Description
- Responds to members general inquiries professionally, thoroughly and accurately
- Provides appropriate forms, paperwork and direction
- Handles and resolves internet banking calls
- Completes wire call back verification's
- Communicates current marketing promotions and educational seminars
- Assist COO and Branch Manager with projects as assigned
- Demonstrate an organized and accountable approach to daily administrative responsibilities
- Validates and tests Bonus Dividends
- Works a rotating Saturday schedule
- Educate prospective and existing enrollees on all aspects of the Plan, answering questions regarding plan's features and benefits
- Active listening skills to accurately respond to inquiries and requests
- Associates degree or comparable advanced education (college level coursework, certification courses, ) or comparable additional work experience
- Answer inbound phone calls effectively by providing the best customer service
- Respond promptly with correct grammar to emails and chats
- Research using inside sources to resolve problems promptly and courteously
- Respond to members concerns in a professional manner