Direct communications with members, providers, and health plans
Confirmation of benefits and eligibility information to members, providers, and health plans
Provide confirmation of participating providers in the network
Provide claim status to members, clients, and providers
Resolve problems by identifying the customer's complaint; selecting and explaining the best resolution for the issue, and escalating to upper management when necessary
Keep managers informed of any issues that may require their attention to avoid or resolve an existing problem
Apply knowledge, experience, common sense, and critical thinking to all issues being dealt with
Multi-task and prioritize
Respond to general inquiries from members and providers (plan benefits, limits, co-pays, deductibles, policy procedures, reimbursements, etc.)
Redirect callers when necessary
Follow up until completion on all issues that are not resolved on the initial contact, and keep parties updated on steps and actions taken
Service the maximum number of callers in the quickest and most efficient way without sacrificing the quality of the service
Job Specifications
Typically has the following skills or abilities:
1+ year of Member Services experience in the Healthcare industry
Proficient with computers
English and Spanish bilingual
For roles that are remote (i.e., Work From Home (WFH)) or hybrid (i.e., partial onsite at a VSP location and WFH), must demonstrate a high level of engagement in virtual environments, including maintaining camera presence during meetings to support effective communication and team alignment
VSP Vision is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, disability, or protected veteran status. We maintain a drug-free workplace and perform pre-employment substance abuse testing.
Preferred Skills
Strong understanding of health plan terminology
Salary Description $15.00 - $17.00
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