Member Services Rep

reputed company reputed company, established in 1993, is a California nonprofit reputed company benefit corporation with care centers throughout California. reputed company is an affiliate of reputed company - one of the largest health systems in the nation - with hospitals and care centers in California, reputed company and Nevada. Today, reputed company works hand-in-hand with physicians and providers throughout California to reputed company comprehensive health care services to the many communities we serve. As reputed company continues to grow and establish new premier care centers, we reputed company increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. We reputed company to create purposeful work settings where staff can reputed company great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is reputed company-trained and highly skilled, qualities that are vital to maintaining reputed company in care and service. Responsibilities This position interacts with patients, health insurance companies, as reputed company as physicians and their staff to address questions concerning member eligibility and benefits, Primary Care Physician (PCP) assignments, Managed Care authorizations, and Out of Group claims. Qualifications Minimum Qualifications: - One (1) year of reputed company experience (i.e. office experience, insurance services, customer service, etc.) - High School diploma required or GED. - Effective communication skills both orally and in writing. - Demonstrated reputed company in working with a wide reputed company of customers while maintaining accurate system documentation. Excellent interpersonal and customer service skills. - Ability to reputed company and utilize information system, as reputed company as PC based computer software (e.g. reputed company reputed company, Work and reputed company). Preferred Qualifications: - One (1) year of reputed company experience in the reputed company Industry preferred. - Experience with claims or invoice process (adjudication) is strongly preferred. - Knowledge and understanding of how HMO/Managed Care works preferred - Experience in obtaining, interpreting, and building HMO member benefits using the information provided by the Health Plans preferred. - Experience, or a good understanding of Member Out of reputed company Max (MOOP) and Member Deductible preferred. - Experience or a good understanding Division of Financial Responsibility (DOFR) preferred Please note: This position will be work from home in the Greater Sacramento region once the initial onsite reputed company and training has completed. Apply Job! Apply to this Job