Member Contact Specialist
The Member Contact Specialist is responsible for increasing member satisfaction by providing professional and accurate responses to incoming inquiries regarding plan benefits, eligibility, claims, transportation, interpreter services, and pharmacy issues. This position maintains an up-to-date and thorough knowledge of PrimeWest Health programs, products, and guidelines and properly documents all calls/contacts as required by department standards in a clear and concise manner. The Member Contact Specialist is responsible for providing accurate research and resolution to member issues in accordance with established procedures and referring unresolved issues to the next level and/or appropriate area when necessary. This position properly identifies issues as possible Grievances or Appeals and follows appropriate procedures accordingly. The Member Contact Specialist attends all departmental meetings and training sessions and maintains strict confidentiality of all sensitive information.
Educational Requirements and Required Qualifications
At minimum, an associate’s degree, or a minimum of three years of experience equivalent to the position requirements
Demonstrated knowledge of, and proficiency in, Word, Excel, and Outlook required. Call center experience is a plus.
Flexibility and ability to handle multiple tasks. Demonstrated organizational skills and attention to detail. Ability to work effectively with a variety of people both within and outside of the organization. Excellent verbal and written communication skills.
Ability to sit at a desk or computer station most of the time. Ability to occasionally lift and/or carry such articles as file folders and small boxes up to 20 pounds.
PrimeWest Health will accept resumes for this position through October 8, 2021. No phone inquiries, please.
Employment to begin approximately October 18, 2021.