Job Type
Full-time
Description
Direct communications with members, providers, and health plans
Confirmation of benefits and eligibility information to members, providers, and health plans
Provide confirmation of participating providers in the network
Provide claim status to members, clients, and providers
Resolve problems by identifying the customer's complaint; selecting and explaining the best resolution for the issue, and escalating to upper management when necessary
Keep managers informed of any issues that may require their attention to avoid or resolve an existing problem
Apply knowledge, experience, common sense, and critical thinking to all issues being dealt with
Multi-task and prioritize
Respond to general inquiries from members and providers (plan benefits, limits, co-pays, deductibles, policy procedures, reimbursements, etc.)
Redirect callers when necessary
Follow up until completion on all issues that are not resolved on the initial contact, and keep parties updated on steps and actions taken
Service the maximum number of callers in the quickest and most efficient way without sacrificing the quality of the service
Typically has the following skills or abilities:
1+ year of Member Services experience in the Healthcare industry
Proficient with computers
English and Spanish bilingual
For roles that are remote (i.e., Work From Home (WFH)) or hybrid (i.e., partial onsite at a VSP location and WFH), must demonstrate a high level of engagement in virtual environments, including maintaining camera presence during meetings to support effective communication and team alignment
VSP Vision is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, disability, or protected veteran status. We maintain a drug-free workplace and perform pre-employment substance abuse testing.
The compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding iCare benefits, please click here.
Strong understanding of health plan terminology
Salary Description
$15.00 - $17.00
iCare Health Solutions is an organized eye care delivery system that specializes in delivering fully-integrated networks of optometric and ophthalmic professionals. Our solution optimizes quality outcomes, reduces health care cost as well as the overall improvement of patient satisfaction. Our distinguished community of eye care providers share the same philosophy of delivering cost-effective and holistic patient-centered care.
Our program utilizes a powerful technology-driven infrastructure supported with simple and effective benefit management services to support integrated eyecare delivery. Through the support of clinical guidelines, standardized patient pathways, and continual investment in technology, our program enables its community eye care providers to focus on providing the most appropriate level of care by the right specialist at the right time.
