Scripps Health Administrative Services supports our five hospitals and 19 outpatient facilities, which treat half a million patients annually through 2,600 affiliated physicians.
At Scripps Health, you will experience the pride, support, and respect of an organization that has been repeatedly recognized as one of the nation’s Top 100 Places to Work.
You’ll be surrounded by people committed to making a difference in the lives of their patients and their teammates. So if you’re open to change, go ahead and unlock your potential.
Join a wonderful team as a Member Service Representative in our Scripps Health Plan Services department at our 4S Ranch Business Services office. In this position, you will play an important role in supporting our patients' incoming calls in a call center environment.
Under general direction, primary responsibilities will include the following:
- Providing customer service to plan members and providers by answering complex benefit questions, resolving issues and educating customers.
- Receiving inbound telephone, internet and written inquiries from members and providers regarding covered benefits, claims, referrals and eligibility.
- Making outbound telephone and email contacts to members and providers to provide education and facilitate issue resolution.
- Managing claim checks, checking referral status', and managing member calls
- Managing member appeals and griviences
- Other special projects as assigned
This is a benefitted Full Time, Day Shift position with a Monday-Friday schedule and 8:30AM - 5PM shift, located at the 4S Ranch Business Services office in Rancho Bernardo.
Required Education/Experience/Specialized Skills:
- 3 or more years of customer service experience.
- 1 or more year of experience in a call center environment.
- Strong written, verbal and listening communication skills.
- Strong problem-solving skills.
Preferred Education/Experience/Specialized Skills/Certification:
- Managed care experience.
- Knowledge of EPIC Tapestry.
- Health Plan experience.
- Health care administration.
Scripps Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with disability.
