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Liviniti, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, Liviniti, LLC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Liviniti, LLC expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Liviniti, LLC employees to perform their job duties may result in discipline up to and including discharge. EOE M/F/D/V
Member Services Agent
Location
United States
Posted
15 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
Member Services Agent
Southern Scripts
Role Description The member services agent is responsible for providing effective customer service for all internal and external customers by using excellent, in-depth knowledge of company products and programs as well as communicating effectively with team members within the customer service department. - Knowledge of principles and processes for providing customer and personal services, including customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction. - Confer with customers by telephone to provide information about Rx claims processing. - Keep detailed records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken. - Follow-up to ensure that appropriate changes were made to resolve customers' problems. - Refer unresolved customer grievances to designated departments for further investigation. - Review Rx insurance policy terms to determine whether a claim is covered for employer group. - Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments. - Resolve customers' service or billing complaints. - Obtain and examine all relevant information to assess validity of complaints and to determine possible causes. - Abide by all obligations under HIPAA related to Protected Health Information (PHI). - If a HIPAA violation is discovered, report the violation to the Compliance Officer and/or Human Resources. - Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company. - Flexibility to understand, appreciate and embrace that this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Qualifications - High School or equivalent. - Customer service experience. - Computer experience. Requirements - Interacting with Computers — Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information. - Communicating with Supervisors, Peers, or Subordinates — Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person. - Getting Information — Observing, receiving, and otherwise obtaining information from all relevant sources. - Communicating with Persons Outside Organization — Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources. - Processing Information — Compiling, coding, categorizing, calculating, tabulating, auditing, or verifying information or data. - Resolving Conflicts and Negotiating with Others — Handling complaints, settling disputes, and resolving grievances and conflicts, or otherwise negotiating with others. - Updating and Using Relevant Knowledge — Keeping up-to-date technically and applying new knowledge to your job. - Organizing, Planning, and Prioritizing Work — Developing specific goals and plans to prioritize, organize, and accomplish your work. - Performing Administrative Activities — Performing day-to-day administrative tasks such as maintaining information files and processing paperwork. - Making Decisions and Solving Problems — Analyzing information and evaluating results to choose the best solution and solve problems. - Customer and Client Focus. - Problem Solving and Analysis. - Time Management. - Communication Proficiency. - Teamwork Orientation. - Technical Capacity. - Multitasking. Benefits - Medical, Dental, Vision Insurance. - Disability and Life Insurance. - Employee Assistance Program. - Remote Work Options. - Generous Paid-Time Off. - Annual Reviews and Developmental Plans. - Retirement Plan with Company Match Immediately 100% Vested. Position Type and Expected Hours of Work This is a full-time, hourly position. Days and hours of work vary on shift assigned. The Call Center core hours of operation are Monday – Friday 6a – 10p, Saturday 6a – 8p, and Sunday 6a - 8p. Travel Minimal travel expected for this position to Natchitoches, Louisiana for training and development.
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