Member Service Representative in Cypress, CA at Beacon Health Options

Date Posted: 7/16/2019

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Member Services Representative to join our team at our office in Cypress, CA.  The Member Services Department is the front line interface to Members and Providers who seek information about behavioral health benefits. Member Services Representatives assist callers by providing benefit and eligibility information and referrals to network providers.  The Member Services Representative transfers clinical calls to clinicians, as defined in the department policies and procedures.  In addition, the Member Services Representative will be responsible for completing specified assignments that assist the department in meeting contractual goals. 

Flexibility with scheduled hours is expected between hours of 8am and 8pm. 

Position Responsibilities:
The Member Service Representative will perform the following duties in a typical call center environment, which means a high volume of calls will handled while located at a desk.  This requires adherence to schedules and extended periods of time on the phone.

  • Answers intake ACD queues and adhere to telephone performance requirements for call response times and abandonment rates
  • Responds to questions about eligibility, benefits and procedures for accessing behavioral health services
  • Verifies patient benefits and eligibility through health plan computer access and phone
  • Performs data entry and route calls to the appropriate resource
  • Determines which calls need to be transferred to a clinician, as defined by referral guidelines and established protocols
  • Documents all call information according to standard operating procedures
  • Educates callers about Beacon/CHIPA services and their behavioral health benefits
  • Follows health plan specific contract guidelines
  • Adheres to all Beacon policies and procedures and standards of operations.
  • Performs special projects and other duties as assigned and required

Position Requirements:

Education: A high school/GED diploma is required.  An Associate’s Degree or equivalent related experience is preferred.

Relevant Work Experience: Minimum of 6 months in an ACD call center environment.

Knowledge, Skills & Abilities:

  • Able to answer and resolve a high volume of member and provider calls effectively
  • Working knowledge of medical billing codes ICD9 / ICD10 and CPT coding a plus
  • Bilingual: Korean, Farsi, Vietnamese, Cantonese, and/or Spanish language skills a plus

TO APPLY

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

#CB
#GD
PM16