Day to Day:

A client of Insight Global is looking for Level 1 and Level 2 Member Service Representatives who will be responsible for the following:

• Resolve incoming calls concerning members eligibility, benefits, provider information, monthly premium billing, medical claims billing, status and clinical and pharmacy need
• Coordinate member plan needs from changing a Primary Care Provider to assisting with clinical or pharmacy related matters
• Accurately document and direct appeals and grievances according to department protocols and procedures and may help with research and resolution
• Research and validate claims and/or billing issues, and follows department procedure and policies to resolve these issues within set timelines
• Reviews and analyzes member claims for accuracy as well as educate members on how benefits are applied

Must Have:

• 2+ years of Call Center experience within a Healthcare OR Health Insurance environment
• Must be comfortable going onsite 5 days a week
• Advanced knowledge and experience with healthcare terminology such as HMO, insurance information, benefits, provider information etc.
• Data entry experience and intermediate computer skills
• Flexible schedule to occasionally pick up shifts within these time frames after 5-6 months M-F 7am 8pm, Sat Sun 8am 6pm after fully trained

Compensation:

$18.00/hr to $19.00/hr.

Exact compensation may vary based on several factors, including skills, experience, and education.

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.