Quick Overview
Job Description
Member Service Rep, MercyCare Insurance Customer Service, Days, 80 hrs / 2 wks
Schedule: Monday - Friday 8:00am - 4:30pm
Responds to all incoming correspondence and telephone inquiries directly related to the position in a professional manner consistent with the health system's mission. Attend seminars/training sessions. They may be required to work overtime during peak periods.
Serve as a resource or Subject Matter Expert (SME) for other team members or internal members in the following areas: Answer incoming phone calls from members and identify the type of assistance the member needs- Members or someone calling on behalf of members Providers Pharmacy
Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
Assist members in navigating Mercyhealth's websites and encourage and reassure them to become self-sufficient
Assist members in choosing a primary care physician and scheduling their first appointment or when assistance getting an appointment is asked for by the member
Research complex issues across multiple databases and work with support resources to resolve member issues and/or partner with others to resolve escalated issues
Meet the performance goals established for the position in the areas of first-call resolution, service level, occupancy rate, percentage of calls held, redirect, attendance, NCQA required audits, and any contractual requirements (ETF, Medicaid, etc.)
Quality - Follows policies and procedures; Looks for ways to improve and promote quality; Applies feedback to improve performance; Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Embraces teamwork, supports and encourages positive change while giving value to individuals.
Microsoft Word & Excel
Knowledge of health insurance is desirable
Knowledge of Epic software Tapestry desirable
Knowledge of coding/medical terminology desired
Must use a computer, keyboard, mouse, and specific computer programs as required. Level of Supervision Some independent judgment is required, but alternatives are limited by standard practices or procedures.
Comprehensive Benefits Package
Mercyhealth offers a retirement plan with competitive matching contribution, comprehensive medical, dental, and vision insurance options, life and disability coverage, access to flexible spending plans, and a variety of other discounted voluntary benefit options.
Competitive Compensation
Mercyhealth offers market competitive rates of pay and participates in various shift differential and special pay incentive programs.
Career Advancement
Mercyhealth offers a number of educational assistance programs and career ladders to support employees in their educational journey and advancement within Mercyhealth.
Employee Wellbeing
Mercyhealth has a focus on wellbeing for employees across the organization and offers a number of tools and resources, such as an employer-sponsored health risk assessment and a Wellbeing mobile application, to assist employees on their wellbeing journey.
Additional Benefits
Mercyhealth employees have access to our internal and external employee assistance programs, employee-only discount packages, paid parental and caregiver leaves, on-demand pay, special payment programs for patient services, and financial education to help with retirement planning.
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