Member Services Representative (Part-Time, Monday - Friday)
UCare Minnesota
 Minneapolis, MN

ABOUT UCARE

UCare offers Medicare, Medicaid, Individual and Family health plans – powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.

WORKING AT UCARE

Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.

Our strong culture has established UCare as a Star Tribune Top 150 Workplace for 10 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.

MEMBER SERVICES REPRESENTATIVE (Part-Time, Monday - Friday)

Hours: 3pm - 8pm Monday, Tuesday, Wednesday, Friday and 3pm - 7pm Thursday

Training for this class will be two weeks full-time; 8am-4:30pm Monday - Friday. Candidates must be available these hours for training.

Position Description

This position is responsible to apply knowledge of UCare's 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.
  • Answer, resolve, track and document telephone calls from members and providers in a timely and professional manner. Interpret member eligibility and coverage through thorough knowledge of the contracts, policies and procedures. Communicate with internal departments, members, providers and other customers regarding the transportation benefit in both verbal and written form, including faxing rides to providers at the appropriate times.
  • Identify trends/issues that emerge in calls/correspondence, and inform 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 UCare 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.

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. 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.

THE UCARE DIFFERENCE

The UCare difference is our people power – employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.