Sr. Member Services Representative

We have an exciting opportunity to join the Alliance as a Senior Member Services Representative in the Member Services Call Center Department.  

This role will be full time on-site in the Mariposa, CA office.

WHAT YOU'LL BE RESPONSIBLE FOR

• Responds to complex member issues and acts as a technical resource for Member Services Representatives
• Acts as a frontline customer service representative within the Member Services Department, providing assistance to members and providers in person and on the phone. 
• Assists with special projects, as assigned.

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here.

• Knowledge of:
  
  • Principles and practices of customer service
  • Managed health care in a health plan environment
  • Eligibility processes and guidelines associated with one or more of the following: the Medi-Cal program, Social Security programs, foster care, adoption assistance, and/or other public assistance programs
  • Conflict resolution techniques
  • Windows-based PC systems and Microsoft Word, Outlook and Excel, and database systems
• Ability to:
  • Answer telephone calls promptly and minimize delays that may lead to missed calls
  • Act as a technical resource for Member Services Representatives
  • De-escalate complex situations, including complaints
  • Translate healthcare-related terminology and complex processes into simple language and step-by-step instructions when communicating with members and providers
  • Gather and evaluate information, ask appropriate questions and utilize active listening and problem-solving skills
• Education and Experience:
  • High school diploma or equivalent 
  • Four years of customer service experience in member services, health care, public assistance, human services or in a customer service or call center environment which included a minimum of  two years of experience in a health care setting which involved assisting members and/or providers with eligibility processes and guidelines (an Associate’s degree may substitute for one year of the general customer service experience); or an equivalent combination of education and experience may be qualifying

OTHER INFORMATION

• We are in a hybrid work environment, and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

The full compensation range for this position is listed by location below. 

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

Last updated on Aug 16, 2024