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Member Services Specialist

Company: Aerotek
Location: Appleton
Posted on: May 11, 2020

Job Description:

Job Title Member Services Specialist Position Overview The Customer Service Representative will research and troubleshoot incoming Customer Care calls from members, providers, and pharmacies in regards to medical related questions. Job Duties Understand, apply, and communicate client-specific prescription benefit and pharmacy claim processing information to include things like: o formularies (list of covered medications), o clinical programs to improve health and reduce costs, o member out of pocket costs o appeal rights o prior authorization/exception processes o and much more Educate members on how to best utilize their benefits Troubleshoot pharmacy claims real-time to include verifying information the pharmacy submits, comparing the claim result to benefit rules, and entering allowed overrides to allow claims to pay Send documents to providers electronically Follow up and provide superior service through outbound calls as necessary Protect all personal health information and abide by all HIPAA regulations and confidentiality requirements Adapt to fluctuations in workload from slower times to extremely busy times Effectively work/communicate with internal teams, such as other Customer Care team members, Prior Authorization, Manual Claims Pay $15/hour Training : 8AM-4:30PM After Training: Must be open to working as late as 8PM About Aerotek: 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.

Keywords: Aerotek, Appleton , Member Services Specialist, Other , Appleton, Wisconsin

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