Member Service Representative (Troy, MI)

at BeneSys, Inc.
Location Troy, MI
Date Posted May 22, 2021
Category Default
Job Type Full-time

Description

Member Service Representative (Troy, MI)
Summary
Responds to incoming telephone calls pertaining to the funds they are trained in from members and providers. Each representative will be required to answer approximately 80-100 calls per day.
Primary Responsibilities
  • Communicates with customers face to face, electronically or via telephone;
  • Assist callers with questions regarding: deductibles, out of pocket accumulators, dental benefits, vision benefits, MRA or Benny Card, Vacation, or SUB Pay;
  • Formulate resolution and respond to inquiries in a timely and accurate manner;
  • Follow-up with customers to ensure that their issues are sufficiently resolved;
  • Make outgoing calls to members, provider’s, collection agency, and vendors, such as Cofinity and Blue Cross & Blue Shield;
  • Maintain records of all interactions with the members/providers;
  • Thoroughly explain group benefits to participants;
  • Status claims when necessary;
  • Request check tracers, refunds and reissue checks;
  • Create task inquiry and follow through after the inquiry has been logged into the system;
  • Mail reimbursement forms and other correspondence to members;
  • Complete precertification’s for members;
  • Complete HDM reports;
  • Coordinate phone coverage with coworkers if they are leaving their desk for short periods of time;
  • Assisting with claims/eligibility issues.
  • Assist members and clients professionally 
  • Read and interpret the plan rules as outlined in the SPD’s, user manuals for on-line services, department rules and procedures manual and COBRA Compliance manual
  • Apply common sense to carry out detailed written or oral instructions
  • Deduce if a balance due is the responsibility of the Member or if the plan has yet to consider the charges
  • Explain to members, dependents, providers and union officials the rules of the plan
Qualifications
Required Qualifications
  • Post high school education or prior related work experience
  • 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 be able to maintain composure with difficult callers
  • Must be able to multi-task
  • Must be detail oriented
  • Quick and accurate typing skills
  • Confidence in handling difficult situations
  • Able to work with customers with diverse backgrounds
  • Willingness to tackle any relevant customer service training
  • Able to work independently and in a team
  • Superior communication skills and keen observation
Preferred Qualifications
  •  Some knowledge of claims processing
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 people want to work, feel proud of what they do and feel fulfilled both professionally and personally; creating 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 and; 
  • Integrity: doing what we say we will do. Upholding strong ethical and moral principles
Work Schedule
Full time. Flexible schedules available with the potential for work from home opportunities after 90 days!
Competitive Benefits & Compensation Package
  • Paid Time Off (PTO)
    • 15 days of PTO during the next calendar year!
  • Medical, dental, vision, and life insurance
  • Company paid short term disability, long term disability, and AD&D insurance
  • 401k with employer match
  • Tuition reimbursement program
  • Paid training
  • Career development opportunities
  • Referral bonus for all full-time referrals
  • Competitive wages
  • Annual opportunities for increases and bonuses
COVID-19 Considerations
  • Masks are required by all employees and clients
  • Daily sanitation procedures in place
  • Daily check-in program with rigorous contact tracing
Pay
Pay commensurate with education and experience.
ADA & EEO
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