Veterans Preferred – Member Services Analyst

California Job Vacancies

Military Veterans are Encouraged to Apply.
 

At Modis, we use our insight, knowledge, and global resources to make exceptional connections every day. With 60 branch offices located strategically throughout North America, we are positioned perfectly to deliver the industry’s top talent to each of our clients. Clients choose Modis as their workforce partner to solve staffing challenges that range from locating hard-to-find niche talent to completing quick-fill demands.

Position: Member Services Analyst I

Type: Contract

Rate: DOE

Location: Camarillo, CA (100% Remote)

Modis Burbank is seeking an experienced Member Services Analyst I in Camarillo, CA

The Member Services Analyst I, will assist members by providing professional, accurate and timely responses to inquiries regarding enrollment, eligibility, plan benefits, provider network, authorizations, plan guidelines and processes. The Member Services Analyst I, will respond to inquiries received from members via telephone call or email. The Member Services Analyst I, will also respond to requests for assistance from other internal departments or external partners.

Essential Functions

Explains procedures, protocols, benefits, services and information to members as required.

Provides accurate information about eligibility, benefits and claim status and authorization requirements to serve members in a courteous and professional manner.

Handles and resolves escalated issues.

Maintains an up-to-date and thorough knowledge of guidelines.

Provides accurate research to resolve issues regarding eligibility, benefits, claims and authorizations using appropriate systems.

Properly documents all calls/contacts as required by department standards in a timely, clear and concise manner using internal tracking system.

Reviews training/educational material and seek clarification when needed.

Provides assistance with member-oriented events.

Maintains strict confidentiality of all sensitive information.

Refers unresolved issues to the next level and/or appropriate area when necessary.

Achieves and maintain acceptable performance levels according to the Member Service standards.

Utilizes documents using Microsoft Office and other applicable software, as designated by management.

Processes member ID card requests and performs other Member Services related tasks, functions and special projects.

Position Qualifications

Management Skills – Ability to organize and direct oneself and effectively supervise others.

Accountability – Ability to accept responsibility and account for his/her actions.

Active Listening – Ability to actively attend to, convey, and understand the comments and questions of others.

Diversity Oriented – Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type.

Communication, Oral – Ability to communicate effectively with others using the spoken word.

Customer Oriented – Ability to take care of the customers’ needs while following company procedures.

Problem Solving – Ability to find a solution for or to deal proactively with work-related problems.

Skills & Abilities

Required Experience: 2 plus years of experience in Customer Service.

Strongly Preferred – Bilingual in English/Spanish. Call center experience a plus.

Preferred experience in the health care field interacting directly with members.

Direct experience with Medi-Cal guidelines and health insurance rules and regulations a plus.

Computer Skills: Intermediate computer skills included in the MS Office products.

Other Requirements: Ability to work collaboratively with others. Ability to be detailed oriented. Ability to provide constructive feedback to peers and members. Familiar with and be able to interpret policy and procedures.

Professionalism – Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.

Quality – Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.

Written Communication – Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information

If interested, please apply, and share your resume at Priyanka.khurana@modis.com

Equal Opportunity Employer/Veterans/Disabled

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The Company will consider qualified applicants with arrest and conviction records

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