Medix Is Hiring A Hybrid Member Service Representative Bilingual

Join us in delivering outstanding healthcare support as a Member Services Representative! 🌟 This role is crucial in providing members and providers with compassionate assistance, ensuring a smooth and informed healthcare experience.

🚑 Member Services Representative (Healthcare)

📝 Position Overview

The Member Services Representative serves as the primary point of contact for members and healthcare providers, offering exceptional customer service and support. Their focus is on helping members navigate their healthcare benefits, access services, resolve concerns, and enjoy a seamless experience.

🎯 Key Responsibilities

• Answer incoming calls from members and providers, addressing questions related to benefits, services, and care plans 📞
• Assist members in accessing covered and non-covered services, including scheduling appointments with primary care physicians and specialists 🏥
• Conduct post-enrollment orientations for members, families, and representatives, explaining plan benefits, policies, and procedures 📋
• Educate members on how to obtain services, use their benefits, and navigate the healthcare system 🧭
• Respond to and document member inquiries, complaints, and grievances; resolve same-day issues when possible 📝
• Inform members of their rights, including grievance and appeals processes, fair hearings, and external review options ⚖️
• Clarify information from member materials, including handbooks and online resources 📚
• Facilitate communication between members, providers, subcontractors, and the Interdisciplinary Care Team 🤝
• Provide medication reminder calls as directed by the care team 💊
• Assist with non-clinical assessments and data entry of service authorizations 🗃️
• Support members with Medicaid renewal and eligibility-related processes ✅
• Communicate effectively with individuals with diverse needs using interpretation services and adaptive communication tools (e.g., TTY, large print, braille) 🌍
• Participate in special projects and support departmental initiatives as needed 🔧

🎓 Qualifications