Remote Jobs at Teksystems

Job Description: The Member Experience Representative’s primary focus is to answer phone or email inquiries from providers, members, customers, or brokers regarding questions of coverage, claim status, benefit interpretation, billing, and/or authorizations. Key Responsibilities: • Answer incoming phone calls efficiently regarding inquiries on coverage, claim status, benefit interpretation, billing, and/or authorizations. • Respond to inquiries within set timeframes to adhere to department metrics and contractual standards. • Probe and ask appropriate questions to identify specifics of caller inquiries to ensure first call resolution. • Document details of interactions within the database, including any additional action steps taken as follow-up. • Follow-up with customers or other departments on outstanding issues or concerns. Escalate appropriate issues to Supervisor or appropriate individual. • Support members by answering calls and proactively work to resolve their questions and c ...