Member Services Representative

York, PA | Clerical and Administrative | Tracking Code: 57327

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Drop-in Open House Event
August 29th
9:00 am - 11:00 am
Register today to speak to recruiters regarding the following positions: Contact Center Specialist, Referral Specialist, Patient Access Call Center Specialist or a Patient Services Specialist.

Position Summary:

 

General Summary:
Under the general supervision of the Manager-Customer Service, explains benefit coverage, answers members'
questions/inquiries, prepares appropriate reports, documents and investigates complaints and coordinates member
appeals.
Duties and Responsibilities:

1 Explains benefit coverage to members and/or providers orally or in writing.
2 Interacts with appropriate sources to answer members' questions/inquiries and resolve members' concerns and problems
orally or in writing. Documents and tracks complaints and coordinates member appeals.

Department Description:

WellSpan Population Health Services provides coordination of health benefits offering a Preferred Provider Organization supporting accountable care and medical management which includes case management and utilization management. WellSpan Population Health Services is committed to provide care in compliance with the WellSpan triple aim: to improve the cost, quality, and patient experience in an efficient and effective delivery system for patients and providers.
 

 

Required Skills

High School or G.E.D.

2 - 3 years in the healthcare/health insurance/managed care industry


Quality of Life

WellSpan Health is an integrated health system that serves the communities of central Pennsylvania and northern Maryland. The organization is comprised of a multispecialty medical group of more than 1,500 physicians and advanced practice clinicians, a regional behavioral health organization, a home care organization, eight respected hospitals, more than 19,000 employees, and 170 patient care locations. WellSpan is a charitable, mission-driven organization, committed to exceptional care for all, lifelong wellness and healthy communities. We are committed to transforming the health of the communities we serve and to educating the next generation of clinicians, staff and leaders.

Quality of Life
Quality of Life

Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.

Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more — within an easy drive of major East Coast cities.

York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)

Equal Opportunity Employment

WellSpan Health is an equal opportunity employer. Employment selection and related decisions are made without regard to sex, race, age, disability, religion, national origin, color or any other protected class. WellSpan Health does, however, have a tobacco-free/nicotine-free hiring policy.

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