Member Services Representative job in Grants Pass

AllCare Health is seeking a Full-Time Member Services Representative who thrives in a team environment and has the ability to provide exceptional service and skills.
AllCare Health is a southern Oregon-based health organization, led by local physicians since 1994. In a progressive model of care, we combine medical, dental, and behavioral health services to provide Medicare, and Medicaid insurance coverage to our members. We also provide support to our providers through AllCare Independent Physician Association and AllCare e-Health Services

The Full-Time Member Services Representative is responsible for providing support to health plan members and providers; serves as a resource person for staff and community medical personnel. Responds to requests for managed care information for all product lines and subsidiaries.

Qualifications:

 Knowledge regarding Medicaid and Medicare and/or medical office experience preferred
 Must be able to type 40 WPM
 Interested applicants with bi-lingual proficiency are encouraged to apply
 A positive and cheerful attitude that reflects favorable upon the organization’s image.
 An educative approach to answering questions and informing people of health plan policies, procedures, or decisions.
 A firm, confident responsiveness that maintains the organization's integrity.
 Must possess a valid Driver’s license.
 The ability to handle sensitive situations and stress effectively, not taking matters personally, and projecting a professional attitude.
 Exceptional customer service skills and ability to work independently.

 Must be able to work occasional weekends and evening shifts.

 Must maintain an excellent attendance record.
 Must possess excellent verbal and written communications skills.
 Ability to multi-task and work in a team environment.
 Must be detail-oriented and set high standards for accuracy.
 Must have demonstrated experience with Microsoft Office Suite.
 Strong interpersonal, organizational, analytical, decision-making, and problem-solving skills required.
 Ability to maintain strict confidentiality of all employee and company information.

Essential Duties:
Talk with members or member's representatives and providers by phone or in person regarding such topics as general benefits, contract interpretation, procedures, billing, subscriber problems, and denied services. Handle inquires in a prompt, courteous manner.
Must be knowledgeable in all contracts, programs, and benefits offered through AllCare CCO, and AllCare Advantage. The representative must also be able to administer policies consistently and in accordance with the contract(s).
Receive inquiries from members and providers regarding problem claims and is responsible for routing these issues to the appropriate person or department for a resolution, responding in a timely manner and documenting the action taken.

AllCare offers a great working environment and competitive benefit package. Candidates offered a position must be able to successfully pass a drug test and background check. Skills testing may be required.
For consideration, please submit your resume, cover letter and a list of your professional references.

AllCare Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status