urgent!! members benef it OfficerMEDICARE PLUS, INC.

JOB DESCRIPTION
Attends inquiries and questions from providers
Verifies and checks the member's coverage plan
Analyzes the request of the provider for consultation and laboratory procedure if these are covered or within the parameter of the member's healthcare plan
Advises the provider regarding the status of approval of the request
Facilitates administration of health benefits to all HMO members or cardholders through proper coordination between the patient and the provider
Handles all inquiries, concerns, and requests of the members relative to their health benefits
Handles complaints and explains when the request is disapproved and assures that all concerns are answered
Conducts orientation for corporate accounts on the benefits, inclusion, limitation, eligibility status, and processing procedures in using the HMO card
Reviews the member's plan and utilization
Updates members' approved utilization
Discusses and explains the healthcare benefit of the member
Processes and issues the letter of authorization to the member
JOB QUALIFICATION
Preferably with at least 2 years of work experience in customer service
Above-average communication and interpersonal skills
Must be customer-service oriented
Must have a keen eye for details
Good negotiating skills
Proficient in Microsoft Office Applications
Must be a graduate of any business-related course
OTHER JOB REQUIREMENTS
Education
Bachelor's Degree / College Degree
Field of study
Medical Science
Specialization
Nurse/Medical Support, Customer Service
JOB BENEFITS
Customer Care Support, Oral and Written Communication, Medical knowledge