"Alerted.org

Description:

+ The Member Experience Representative’s primary focus is to answer phone, or email inquiries from providers, members, customers or brokers regarding questions of coverage, claim status, benefit interpretation, billing and/or authorizations.

+ Proficient in one line of business, either Medicare or Group/Marketplace, translating health care related jargon into effective written or verbal communication for the end user to comprehend.

+ Document details of the interaction within the database, including any additional action steps taken as follow up.

+ Demonstrate commitment and behavior aligned with the philosophy, mission, values and vision of Network Health

+ Appropriately apply all organizational, regulatory, and credentialing principles, procedures, requirements, regulations, and policies

+ Answer incoming phone calls from members, customers, providers or brokers efficiently regarding their inquiries on coverage, claim status, benefit interpretation, billing and/or authorizations. Respond to inquiries within set timeframes to adhere to department metrics and contractual standards.

+ During telephone call, probe and ask appropriate questions to identify specifics of what caller is inquiring about to ensure first call resolution.

+ Follow-up with customers or other departments on any outstanding issues or concerns. Escalate appropriate issues to Supervisor or appropriate individual.

Top Skills Details:

+ Call center experience needed

+ insurance

+ Medicare experience needed

+ group insurance

+ benefit interpretation

+ claims

Pay:

+ $17 to $18.25

Training:

+ Monday to Friday

+ 8am to 4pm

+ 6 to 8 weeks

Shift:

+ Monday to Friday

+ 8:30am to 5pm

+ 9am to 5:30pm

Location:

+ Remote in the state of Wisconsin

Pay and Benefits

The pay range for this position is $18.25 - $18.25/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on May 14, 2025.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.