• Member Services Representative

    Posted Date 2 weeks ago(3/9/2018 5:28 PM)
    Requisition ID
    # of Openings
    Area of Interest
    Elderwood Health Plan
    Position Type
    Regular Full-Time
  • Overview

    The Member Service Representative (MSR) is a part of the managed long term care interdisciplinary care team with responsibility for executing the non-clinical aspects of a participant's care as determined by the RN and MSW. This includes important functions such as assessments, supporting care plan development, authorizations, paperwork, and service ordering, handling participant inquiries, and essentially executing all of the "mechanics" behind the scenes. Specialists work seamlessly with assigned Care Managers to ensure everything that a participant needs to tend to their health is arranged or taken care of. The MSR also serves as the primary point of contact for members. The MSR will assist clients with questions, concerns and problems; offering solutions to our members regarding insurance policies and processes, billing, payments and plan changes.



    • High School Diploma. An Associate's Degree preferred.
    • Minimum 1 year experience in health care and/or regulatory related environment or in member services at a health agency or plan.
    • Minimum of one (1) year experience working with a frail or elderly population.
    • Must be in good standing with the Medicare and Medicaid programs.
    • Bilingual skills are preferred, but not required.
    • Knowledge of medical terminology, CPT-4 and ICD-9 coding, preferred but no required.



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