Skip to Main Content
← Back to Jobs

Member Liaison

Questpro Saint Petersburg ,FL
  • Posted: over a month ago
  • $19 Hourly
  • Full-Time
  • Benefits: dental, medical, vision
Job Description

Job Description

A Member Liaison is responsible for providing education and excellent customer service to Health Plan members.

One of the most important roles of the Member Liaison is the ability to act independently within the scope of their duties/responsibilities and ensure appropriate resolution to all inquiries and issues.

ESSENTIAL JOB FUNCTIONS:

  • Respond to inbound calls from Plan members and providers regarding balance bills and take appropriate action to resolve
  • Make outbound calls to Plan members and providers regarding balance bills and take appropriate action to resolve
  • Educate members and providers on Health Plan and Plan payment methodology
  • Work with providers in effort to gain their acceptance of the Health Plan reimbursement methodology
  • Generate provider balance bill letters and correspondence
  • Negotiate with providers within parameters/guidelines of the Health Plan
  • Assure the confidentiality of calls and documents
  • Document all calls in the Patient Advocacy system
  • Liaison with TPA claims Staff

Other Responsibilities as Assigned:

  • Special projects as assigned
  • Miscellaneous office duties
  • Back-up to other positions

Job Requirements

  • High School diploma or equivalent.
  • Higher degree of education or vocational/technical school in health care industry preferred but not required
  • Excellent verbal, written and customer service skills
  • Minimum of 2 to 3 years Healthcare/Insurance Industry experience in patient advocacy, customer service, provider relations, claims or billing/collections preferred
  • Solid computer, grammar and multi-tasking skills
  • Strong attention to detail, time management and decision-making skills
  • Professional demeanor
  • Demonstrated job stability

EQUIPMENT SKILLS:

  • Computer, different types of software, windows, excel access
  • Office Equipment, faxes, copiers
Company Description
Questpro is a full-service recruiting firm focused solely on the Insurance and Risk Management industry. From a recent college grad to an experienced professional all the way to a CEO, we save the day by seeking out the best in the business at all levels. Our services of expertise include Retainer, Direct-Hire, Contract/Contract to Hire and Consulting Practices.

Questpro

Questpro is a full-service recruiting firm focused solely on the Insurance and Risk Management industry. From a recent college grad to an experienced professional all the way to a CEO, we save the day by seeking out the best in the business at all levels. Our services of expertise include Retainer, Direct-Hire, Contract/Contract to Hire and Consulting Practices.

Address

Saint Petersburg, FL
USA

Website

What email should the hiring manager reach you at?

By clicking the button above, I agree to the ZipRecruiter Terms of Use and acknowledge I have read the Privacy Policy, and agree to receive email job alerts.

What email should we contact you at once we get salary info from the hiring manager?

By clicking the button above, I agree to the ZipRecruiter Terms of Use and acknowledge I have read the Privacy Policy, and agree to receive email job alerts.

Our qualification feature is only available to registered members - what email address would you like for us to keep on file?

By clicking the button above, I agree to the ZipRecruiter Terms of Use and acknowledge I have read the Privacy Policy, and agree to receive email job alerts.