Humera - Administrative and Professional Staffing

Member Service Representatives - Bilingual

Minneapolis, MN, United States
Contact For Rate
Jul 05, 2017
Jul 08, 2017
Job Type
Employment Status
Full Time
Humera has several positions available for Bilingual Member Service Representatives with our client in NE Minneapolis. This company is an independent, nonprofit that provides health coverage and services.  These are long-term contract opportunities.

Applicants must be fluent in Spanish or Somali.

This position is responsible to apply knowledge of our clients business, products, members and operations to accurately and effectively fulfill member service requests and inquiries. Ensure adherence to policies and procedures and meet service level expectations by following established guidelines and standards. Achieve fluency in at least one core product or service line.

  • Answer, resolve, track and document telephone calls from members, providers, internal departments, and external agencies, in a timely and professional manner
  • Research, resolve and communicate effectively with internal and external customers regarding member/provider concerns or issues
  • Educate members and external customers on policies and procedures related to members' health care program
  • Research and resolve inquiries from internal /external customers including: Enrollment, eligibility, ID cards, clinic changes, demographic changes, benefit coverage, claims, payments, member reimbursement, and demonstrated knowledge of CAG policies, procedures, and regulations
  • Utilize appropriate resources to respond to member inquiries
  • identify trends/issues that emerge in calls/correspondence, and inform Team Lead or Supervisor
  • Assist in the development and communication of resolutions to internal staff, as requested
  • Demonstrate and maintain a thorough and complete working knowledge of appropriate information management systems, and ACD telephone system
  • Maintain good working relationships and open communication with internal and external customers
  • Attend department and other meetings as requested.
  • Other projects and duties as assigned

    Required Education:
  • High school graduate or the equivalent
  • Two-year degree in health related, liberal arts or communication field, including a course in medical terminology is preferred
    Required Experience:
  • One year call center experience or two years customer service experience
  • Fluency in Spanish or Somali
  • Preference given to candidates with health insurance (HMO), physician group practice, or community agency
  • Proficient PC skills required knowledge of Microsoft office
    Preferred Experience
  • Working knowledge of medical claims and/or medical billing processes
  • Proficient computer skills; knowledge of Microsoft office, Amisys, and MACESS type software packages

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