Pacific Medical Centers Benefits Representative in Seattle, Washington
PacMed is looking for a current employee to develop his or her career with this new opportunity: Member Services Representative (Benefits Rep) at Pacific Medical Centers in Seattle, WA.
The Member Services Representative provides customer service to all managed care patients of Pacific Medical Clinics as well as provides member services activities for existing and new Medical Services Organization (MSO) business; action initiates through the automatic call distribution system (ACD), written inquiries and direct member contact; activities include timely, accurate and thorough responses to telephone, written and direct member contact inquiries as well as explanation/verification of benefits, customer education, resolution for both internal and external complaints and patient advocacy.
Schedule: Monday - Friday, 8am - 4:30pm
In this position you will:
Represent the USFHP on behalf of the Plan as well as on behalf of PMC; interprets benefits of the USFHP and decides whether coverage exists
Communicates with beneficiaries regarding specific coverage or lack of coverage
Informs non-eligible military beneficiaries of other health coverage options
Orients new enrollees to their coverage and the workings of the Plan
Records and tracks interactions with/about a plan beneficiary
Interacts with patients to answer inquiries regarding benefits, referral status, claims, PMC system, etc
Represent PMC to all managed care patients, i.e. those who choose PMC as their provider through a managed care plan option
Assists with maintenance of correct information on computer systems
Coordinates activities with other sections of the Managed Care Department, as appropriate
Manages ongoing assigned project responsibilities
High school diploma or GED
Two (2) years experience in healthcare field customer service position
Understanding of the theories and principles of customer service
Knowledge of health care delivery and health insurance issues
Post secondary education
Medical claims processing experience
Managed care knowledge
Knowledge of CHAMPUS benefits
About Pacific Medical Center:
Pacific Medical Center is an expanding network of outpatient clinics providing primary and specialty care to the greater Seattle area and employing more than 150 providers representing most medical specialties. Pacific Medical Centers is affiliated with Providence Health & Services, which operates 28 exceptional not-for-profit hospitals and more than 350 clinics across the West. With hundreds of physician and advanced practice provider opportunities in virtually all specialties at any given time, Pacific Medical Centers and Providence offer diverse locations, lifestyles and practice models. Find what you are looking for in your next practice opportunity with Pacific Medical Centers! Learn more at www.pacmed.org/providerjobs
We offer a full comprehensive range of benefits — see our website for details —
Our mission is to provide respectful, high-quality, patient-focused healthcare to each person and to the communities we serve.
Quality and respect. These are the words Pacific Medical Centers (PacMed) employees live and work by. PacMed is a private, not-for-profit, primary and integrated multispecialty health care network with 11 outpatient clinics across the Puget Sound region and more than 150 primary and specialty care providers. Affiliated with the Providence Health & Services system, PacMed provides patient-focused health care — and even same-day appointments — to nearly 100,000 patients in King, Snohomish and Pierce counties. We provide immediate access to cutting-edge technology, first-class facilities and board-certified specialists, many of whom have been listed as among “Seattle’s Best Doctors.”
Pacific Medical Centers, PacMed, and their Affiliates' (collectively “PacMed”) comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. PacMed does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Job Category: Health Plans
Req ID: 181575