healthcare member service agent.

We're seeking a Member Services Agent to join our team and provide excellent customer service to internal and external clients. In this role, you will use your in-depth knowledge of our products and programs to assist customers over the phone with Rx claims, billing complaints, and other inquiries. You'll be responsible for meticulously documenting all interactions, escalating unresolved issues to the appropriate departments, and ensuring customer problems are fully resolved. Ideal candidates will have prior customer service and computer experience, a healthcare background, problem-solving skills, and a proven ability to multitask in a fast-paced environment. This is a full-time, hourly position with a 24/7 contact center, so a flexible schedule is a must. 

salary: $18 - $20 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

Key responsibilities include:
 Providing information about prescription (Rx) claims processing via telephone.
 Maintaining detailed records of customer interactions, including inquiries,
complaints, and actions taken.
 Following up with customers to ensure their problems are resolved.
 Reviewing Rx insurance policy terms to determine claim coverage for employer
groups.
 Contacting customers to provide claim investigation results or inform them of
planned adjustments.
 Resolving customer service or billing complaints by assessing the validity of
grievances and determining causes.
 Referring unresolved issues to designated departments for further investigation.
 Adhering to all HIPAA regulations concerning Protected Health Information (PHI).
 Reporting any discovered HIPAA violations to the Compliance Officer and/or
Human Resources.
 Completing all required company HIPAA training.
 Being adaptable, as duties and responsibilities may change based on business
needs.




Skills

Active Listening

Telephone Etiquette

Empathy

Basic Software Skills

Customer Service

Healthcare

HIPAA

Qualifications

Years of experience: 2 years

Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.