MOOP (Member out of Pocket) Customer Service Specialist - Network Management - Position #2019-118

MOOP(MEMBER OUT OF POCKET)CUSTOMER SERVICE SPECIALIST (2 POSITIONS)- POSITION #2019-118

Date Posted:
Close Date:
2019-04-18
Classification:
Administrative
Type
Full Time
Location
Redlands Monday - Friday 8:00a.m. - 5:00p.m.

Job Description

The MOOP Customer Services Representative serves as a point of contact for all Managed Care Health Plans, Members and Providers. They will be responsible for resolving complaints and inquiries regarding authorization, billings and claims, as well as the Member Out of Pocket (MOOP). They will be required to run reports, researching member’s accounts using the Practice Management System and EZ cap, send notifications to internal staff and external clients/providers, and process any copay refunds to Members and Providers.   

Qualifications

Two years college education, preferably in a health care or business related field. Bachelor’s Degree in Business Administration preferred. Three years of Claims Processing Experience in a healthcare or similar industry that includes one year experience providing Customer Service or Care or one year experience working with a Practice Management System performing A/R (Corrections, distributions, and reversing payments and requesting refunds) duties. Must have knowledge of EZ cap; Must be proficient in the application and use of Windows, Word, Excel, Outlook and the internet; Thorough knowledge of insurance benefits covered by contracting health plans.

 

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