Bi-Lingual Member Service Rep

Scope and Purpose of Position:Respond to telephone inquiries from members and/or providers for optometry services with an emphasis placed upon verifying eligibility, confirming benefits, facilitating the referral/authorization processes, and serving as the first point of contact for member complaints/grievancesJob Function:¨Respond to telephone inquiries from members and/or providers for optometry services with an emphasis placed upon verifying eligibility, confirming benefits, and facilitating the referral/authorization processes for optometry services¨Review, complete, and direct authorization log forms¨Identify and document claims/billing issues prior to directing documentation to claims management¨Serve as the initial point of contact for member complaints/grievances
¨Document and direct complex member issues to the appropriate management level
¨Prepare and distribute written correspondence in accordance with guidelines established by claims administration and industry standard business practices
¨Assist with other duties as may be assigned
REQUIREMENTS
Qualifications:
Education: High School Diploma or GED
Experience:Entry level position; knowledge of medical terminology and managed care preferred but not requiredSkill Sets:Highly organized and articulate individual with excellent verbal and written communication skills; Bilingual-fluent in Spanish; The ability to “smile through the phone,” work independently, and maintain a steady approach to the delivery of quality customer service throughout the work day are a must; Good problem solving abilities required; Basic keyboarding skills required; Computer literacy with an emphasis placed upon Microsoft Office Products preferred.
Please indicate salary requirements in cover letter.