Member Services Representative

High Desert Medical Group is seeking a full time Member Services Representative. This individual will be responsible for a variety of tasks that lead to a high level of customer satisfaction. Member Service Representative is responsible for receiving incoming calls, for greeting and assisting all walk-in patients, and recording questions and concerns regarding medical group services. Must maintain a professional, positive and caring attitude at all times.

SPECIFICS:

• Assist members with needs such as directions, answering questions, PCP selection, scheduling transportation, and accepting any forms.
• Advise members of referral, denial, appeals and grievance processes.
• Serve as a liaison for patients and physicians to assist with concerns and complaints.
• Work closely with Health Education Department and Surgery Coordinators regarding patients.
• Process complaints and work with appropriate staff to resolve them.
• Track and trend complaints for QIC and Administration.
• Provide follow-up contact with patients to assure satisfaction with resolution.
• Assist Member Services staff with department responsibilities.
• Keep a log of daily phone calls and walk-in patients, and e-mail correspondence from website.
• Enter complaints, inquiries, and compliments in appropriate databases.
• Assist pharmaceutical representatives by contacting provider offices, maintaining sign-in logs, and distributing visitor badges.
• Know and understand HDMG policies and procedures and all of the health plans accepted.
• Retain resource materials at desk for reference and/or give to patients.
• Maintain incoming memos folder and department meeting minutes.
• Perform other duties as assigned.

The pay range for this position at commencement of employment is expected to be between $23.58 - $31.43/hr, non-exempt; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience. The total compensation package for this position may also include other elements, including a sign-on bonus, restricted stock units, and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

Qualifications

EDUCATION, TRAINING, EXPERIENCE:

• High school graduate or equivalent.
• Prior experience in customer service preferred.
• Ability to work in a multi-task, high stress environment.
• Bilingual in Spanish preferred.