Member Services Representative
Where
- Wall, NJ
What you'll be doing
- This position is responsible for performing various administrative functions to support the nurse case managers. Screen all incoming telephone calls, responding to pre-certification requests and other inquiries, and direct calls to appropriate nurse case managers if necessary. Handle the scheduling of second opinion examinations as directed by nurse case managers. Assist in the development and maintenance of unit service tracking system. Document daily fast track case management activities. Record daily tracking statistics and production volume, and prepare monthly tracking reports to be reviewed by claim managers. Retrieve medical reports from fax machines and inputs them into a system using appropriate coding. Distribute medical reports to nurse case managers. Follow up with providers for second visit status reports. Process, sort and distribute incoming mail. Handle additional administrative responsibilities as directed by management, including filing faxing, and preparation of outgoing express courier packages.
What your background should be
- Requires a minimum of one (1) to two (2) years of workers compensation or no-fault claims payment processing and administrative processing. Valid driving license and access to a registered, insured automobile. Requires technical knowledge of workers compensation and no-fault laws. Requires knowledge of workers compensation managed care and no-fault early intervention. Requires knowledge of medical terminology and reference materials. Requires knowledge of pc software (i.e. Windows). Requires the ability to work independently within the team, with minimal supervision. Requires excellent written and verbal communication skills. Must be customer service oriented. Must be flexible, adaptable and decisive. Must have the ability to document and analyze production statistics and other service related issues.
Required Schooling / Training
- High school diploma required.
Who is the client company
- The hiring company provides quality health insurance products and services.
- If you are interested in this position, send your resume to apply@kochdavis.com
