Job Details

Membership Services Coordinator

  2024-11-14     COOPERATIVE OF AMERICAN PHYSICIANS     all cities,CA  
Description:

The Membership Services Coordinator performs customer service functions to service external and internal customers via telephone and electronic means including, but not limited to, email and Microsoft Teams application. Also provides administrative and technical support to senior-level Membership Services team members, including the Vice President.


ESSENTIAL DUTIES AND RESPONSIBILITIES:

Provide service to MPT members and groups:

  • Receive calls from Members and answer questions within level of knowledgebase and authority
  • Provide customer service support to members, their support staff, or management teams who call for service or submit service requests by email or US Mail.
  • Timely respond to billing, assessment, and other financial inquiries
  • Timely triage risk management and patient safety hotline calls per appropriate guidelines; follow prepared scripts to respond to requests for basic information, documents, and questions; enter information into Risk Management system as appropriate.
  • Timely triage claims reporting per appropriate procedures, input information into the CAP system, and forward information to the appropriate Claims Manager for follow-up.
  • Timely review and evaluate Coverage Update Forms (CUF) with emphasize on material changes reported by members.
  • As needed, handle overflow calls from other departments.
  • Provide technical support for Members Only, CAP Privileges Online and other www.CAPphysicians.com online systems.
  • Exercise reasonable judgment for the appropriate transfer of phone calls above a predetermined level of authority.
  • Timely process special applications, status changes including termination, retirement, disability, part-time, early cessation, non-private practice, coverage limits change, death, etc.
  • Timely process Employee and Other Related Persons Applications for review and approval by Account Managers.
  • Timely process and approve Locum Tenens requests within authority level.
  • Timely update special conditions and/or waivers in the CAP System.
  • Timely update member records in the CAP System in accordance with policies and procedures.
  • Continuously, through the workday, monitor OnBase workflow queues and inbox, emails, physical inboxes (for US Mail), Microsoft Teams postings and conversations.


Miscellaneous:

  • Provide support to VP of Membership Services for projects as needed.
  • Perform other duties as assigned.


EDUCATION and/or EXPERIENCE:

High School diploma or GED

College degree preferred

Two years customer service experience in the insurance industry, healthcare field, or equivalent combination of education and experience


OTHER SKILLS and ABILITIES:

Excellent communication and organizational skills (oral and written)

Professional phone etiquette

Ability to handle multiple tasks simultaneously

Proficient in Microsoft Word, Excel, Outlook, and Teams.

Ability to work both independently and as a team


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