Must Be: Bilingual in Spanish and have Call Center Experience
We are actively seeking to hire a Member Services Advocate to serve members by being an advocate and point of contact for member questions and concerns regarding benefits, eligibility, referrals, claims and any other aspects of plan benefits and services. Must be able to ensure member satisfaction by providing superior customer service and a willingness to help at all times while maintaining a professional demeanor.
Provide quality customer service by applying SCAN Five Service Principles. Educate members, family, friends, providers and caregivers regarding benefits and plan options.
*Follow up with members by clarifying the customer's issue, determine the cause, and identify and explain solutions. Escalate appropriate member issues to management or other departments as required.
*Consistently meets and/or exceeds the departmental standards, including, but not limited to: quality, productivity, and adherence to schedule and attendance.
*Respond appropriately and in a timely fashion to members/internal staff/ and providers by answering telephonic and written inquiries concerning benefits, eligibility, referrals, claims and all other issues while following departmental policies and procedures and job aids. Follow up on issues, focusing on providing solutions and options for member, as necessary through resolution of member issue.
*Increases member satisfaction by following up and resolving member issues, complaints, and questions in an efficient, timely and accurate fashion; coordinates resolution with providers and other departments as needed.
*Follow all appropriate Federal and State regulatory requirements and guidelines applicable to SCAN Health Plan operations, as documented in company policies and procedures. Follow all HIPAA requirements.
*Documents transactions by completing applicable member forms and summarizing actions taken in appropriate computer system and following standards set by the department or by other authorized individuals.
We know that a company's success starts with its employees. We also know that an individual's success starts with the right career opportunity. As a Best of Staffing® Client and Talent leader, Aerotek's people-focused approach yields competitive advantage for our clients and rewarding careers for our contract employees. Since 1983, Aerotek has grown to become a leader in recruiting and staffing services. With more than 250 non-franchised offices, Aerotek's 8,000 internal employees serve more than 300,000 contract employees and 18,000 clients every year. Aerotek is an Allegis Group company, the global leader in talent solutions. Learn more at Aerotek.com.