Member Provider Services Representative (Call Center)

Location: Clearwater, FL

Company:  Premier Administrative Solutions

Premier Administrative Solutions is a Third Party Administrator (TPA), headquartered in St. Petersburg, Florida with satellite offices in Columbia, SC and Louisville, KY. Premier has been a leader in developing, implementing, and managing administrative services for self-funded and fully-insured programs, individual and group products in both the government and commercial arenas.

Summary:

The Member Provider Services Representative interacts with members and providers to supply information in response to inquiries and conducts member and provider outreach.

Essential Duties and Responsibilities:

  • Answers incoming telephone calls
  • Researches and responds to inquiries regarding benefits, eligibility and claim status
  • Initiates and tracks any and all required follow-up to properly satisfy inquiries
  • Documents all information regarding each call in the system’s inquiry notes field
  • Reviews and keeps updated on applicable program, plan and policy provisions
  • Conducts member retention calls
  • Responds to inquiries in an accurate and timely manner
  • Participates in special projects
  • Assists Supervisor with other duties as required

Other Responsibilities:

  • Adheres to the policies and procedures of Premier Administrative Solutions
  • Maintains strict confidentiality of client, company and personnel information
  • Demonstrates a strong commitment to the mission and values of the organization
  • Adheres to company attendance standards
  • Performs other duties as assigned

Supervisory Responsibilities: None

Competencies:

  • Strong organizational and interpersonal skills
  • Excellent written and verbal communication skills
  • Detail oriented
  • Ability to multi-task and work independently
  • Ability to project a professional, caring and helpful attitude

Qualifications:

  • A minimum of one (1) year of health care industry experience (within a call center) is required

Education and/or Experience:

  • High school graduate or equivalent
  • Knowledge of medical terminology, billing, claims, and the health insurance industry

Certificates, Licenses, Registrations: None

Computer Skills:

Proficiency using a Windows XP computer platform

Environmental Factors/Physical Demands:

Work is performed in an office environment. While performing the duties of this job, the employee is regularly required to have the ability to maintain active customer and employee communication; access, input and retrieve information from the computer system; enter alpha-numeric data into a computerized system often while listening on the telephone. May be subject to repetitive motion such as typing, data entry and vision to monitor. May be subject to bending, reaching, kneeling, stooping, and lifting up to thirty (30) pounds.

To apply, please forward resume to careers@premieradministrativesolutions.com

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