Pacific Medical Centers Member Services Representative - Uniformed Services Family Health Plan in Seattle, Washington
Find what you’re looking for in your career, at PacMed as a Member Services Representative (1.0 FTE, Day Shift) to work in Uniformed Services Family Health Plan (USFHP) in Seattle, WA.
Provides customer service to all members of US Family Health Plan at Pacific Medical Clinics. Uses automatic call distribution system (ACD) to interact wiht members and providers who call for assistance. Sorts mail and responds to written inquiries from members and providers. Provides timely, accurate and thorough responses to telephone, written or direct member inquiries. Provides explanation or verification of benefits, member education, and assists members who have complaints or grievances.
In this position you will:
Researches Plan benefits and informs members of coverage details, informs non-eligible military beneficiaries of other health coverage options; orients new enrollees to their coverage and the workings of the Plan; accurately records and tracks interactions with beneficiaries and providers; interacts with members and providers to answer inquiries regarding benefits, referral claims statuses; interacts with military agencies as appropriate, on behalf of USFHP regarding any uniformed services beneficiary receives complaints or grievances from beneficiaries regarding the Plan or health care delivery provided through the USFHP; guides beneficiaries in the appeals process; assists patients in choosing or changing their clinic and/or primary care provider; assists members in appointment access issues; assists members with billing issues; provides business staff with eligibility and benefit information.
Maintains working knowledge of the Plan (structure, benefits, and exclusions).
Assists with member orientation, as appropriate.
Assists, if requested in the design and content of written materials for publication.
Assists wiht maintenance of correct information on computer systems.
Required qualifications for this position include:
H.S. Diploma or GED
2 years experience in healthcare field customer service position
Preferred qualifications for this position include:
2 years experience in healthcare field customer service position in an HMO setting.
Medical claims processing experience.
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 10 outpatient clinics across the Puget Sound region and more than 175 primary and specialty care providers. Affiliated with the Providence Health & Services system, PacMed provides patient-focused health care — and even same-day appointments — to 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: Customer Service
Req ID: 288428