McLaren Health Care

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Customer Service Representative, to join in leading the organization forward.
MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).
MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.
Learn more about McLaren Health Plan at <a href="https://www.mclarenhealthplan.org" rel="nofollow noopener" target="_blank">https://www.mclarenhealthplan.org</a>
Position Summary:
This position will be responsible for daily member telephone calls which will include directing members to the proper services needed, educating members, problem solving, and creating linkages to the Medical Management Department for authorization of services. Also may be responsible for assisting providers with eligibility, benefit, and resolution of claims issues.
Qualifications:
Required:
<ul>
<li>High School Diploma or equivalent certification.</li>
<li>One (1) year experience in a customer service related role with direct contact with customers via telephone, email, chat and/or face-to-face.</li>
</ul>
Preferred:
<ul>
<li>One (1) year experience in a physician health care office environment or high-volume call center.</li>
<li>One (1) year experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions.</li>
</ul>
Additional Information
<ul>
<li>Schedule: Full-time</li>
<li>Requisition ID: 26004656</li>
<li>Daily Work Times: 10:30 AM - 7:00 PM</li>
<li>Hours Per Pay Period: 80</li>
<li>On Call: No</li>
<li>Weekends: Yes</li>
</ul>
<h4>About Us</h4>
The McLaren system includes 12 hospitals across the state, ambulatory surgery centers, imaging centers, a 730-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 242,000 Michigan lives, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network, and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, a National Cancer Institute-designated comprehensive cancer center. McLaren has 20,000 full-, part-time and contracted employees and more than 93,000 network providers throughout Michigan.

Customer Service Representative, Medicare Advantage

Customer Service Representative, Medicare Advantage

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