Membership Services Clerk (Washington, DC) Job at BeneSys, Inc.
Membership Services Clerk (Washington, DC)
Summary – Responds to incoming telephone calls pertaining to the funds they are trained in from members and providers.
Essential Duties and Responsibilities include but not limited to:
- Ability to address member inquiries, questions and concerns in all areas including basic eligibility, claims, health care benefit interpretation, proper referrals and required authorizations for medical care
- Provides available information upon request and escalates issues as appropriate to Supervisor and/or Manager
- Ability to communicate clearly with accurate information to callers either by telephone, electronic messaging or face to face interaction
- Retain records of calls by documenting these calls in the appropriate systems for tracking
- Ability to multi-task, respond to questions correctly, accurately and resolve the issue from initial contact with caller
- May be assigned special projects
- If the Clerk is assigned on the Provider Portal or any type of electronic messaging system, they will be expected to consistently meet the minimum productivity requirement of responding to at least 40 electronic messages per day, provided there is enough message volume to meet that expectation; for phone Agents a minimum of 50+ calls/day is expected
- Regular and predictable attendance is an essential function of this job
Qualifications - To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to exhibit compassion and patience for the members who need a little extra time to express themselves
- Must have good conflict training, analytical skills, problem solving skills and organizational skills
- Must assist members and clients professionally and to the best of his/her ability
- Some knowledge of claims processing
- Must be able to have knowledge of and handle multiple group benefits
- Quick and accurate typing skills
- Must be able to multi-task and be detail oriented
- Solid knowledge and understanding of essential healthcare terminology and benefits’ definitions and applications (i.e., deductibles, out of pocket, co-pay, etc.), all of which will be reinforced during training for the role
- Ability to diffuse irate calls and offer resolution utilizing the guidelines provided in company-provided training
- Ability to provide accurate claims’ status and provide claims’ resolution within an acceptable turnaround time
- Good working knowledge of Microsoft suites: Excel/Word document
Supervisory Responsibilities – None
Education and/or Experience – Post High School education or prior related work experience.
Language Skills – Ability to read and interpret; the plan rules as outlined in the Summary Plan Description (SPD), user manuals for on-line services, department rules and procedures manual and COBRA compliance manual. Must be able to speak clearly and effectively and to explain to members, dependents, providers and union officials the rules of the plan. Must have superior written and verbal communication skills.
Mathematical Skills - Ability to apply concepts of basic addition, subtraction, multiplication and division.
Reasoning Ability - Representative must be analytical. Representative must be able to deal with people in stressful situations. Superior communication skills and keen observation is essential. Careful attention to what a caller is asking for and then using good judgment. Ability to apply common sense to carry out detailed written or oral instructions. Ability to deduce if a balance due is the responsibility of the Member or if the plan has yet to consider the charges.
Certificates, Licenses, Registrations - None required.
Physical Demands - Occasional lifting of paperwork and printer paper. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Work Environment - Noisy, pressured, stressful. Fast paced department. Phone calls are continuous and often unpleasant. Must be able to maintain composure with difficult callers, work independently as well as in a team. Confident to handle difficult situations. Able to deal with customers with diverse backgrounds. Willing to tackle any relevant customer service training. Must be flexible and willing to pitch in and work together as a team member and must be willing to help other departments within the company.
Work Schedule
Full time, Monday - Friday, 8:00am - 5:00pm, Required in office (no at-home days)
Pay
This is a union position. The pay range is $22.29 - $ 23.65 per hour and is dependent on location, experience, skills, education and other business factors.
Competitive Benefits and Compensation Package
- 14 paid holidays
- 10 paid vacation days
- 12 paid sick days
- 6 weeks paid adoption/foster care leave
- Employer-paid basic life
- Long-term disability and short-term disability insurance
- Up to 5 days paid bereavement
- Supplemental jury duty pay
- Medical, dental and vision insurance, with option for dependent coverage
- 401(k) with employer match
- Tuition reimbursement
Our Culture
BeneSys wants to be a great service provider to the members we serve, and we recognize we can only do that if we are also a great employer with successful employees. In short, our success is driven by our employees successes. We want to be a place where people want to work, feel proud of what they do and feel fulfilled both professionally and personally. We want to create a place where employees can find long-term growth and potential.
Our culture focuses on three core values:
- Collaboration: working together across 31 locations to achieve the best for the company and our clients
- Dedication: striving to create an environment where all employees work toward a common goal while committing to providing the best customer service to our members and our colleagues
- Integrity: doing what we say we will do. Upholding strong ethical and moral principles
ADA & EEO
Reasonable accommodations will be made so that qualified individuals with disabilities are able to complete the application process and, if hired, fulfill the essential functions of their job.
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