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Member Services Associate

Company: Aston Carter
Location: Ontario
Posted on: July 30, 2022

Job Description:


We are actively seeking to hire a Member Services Advocate to serve members by being an advocate and point of contact for member questions and concerns regarding benefits, eligibility, referrals, claims and any other aspects of plan benefits and services. Must be able to ensure member satisfaction by providing superior customer service and a willingness to help at all times while maintaining a professional demeanor. Provide quality customer service by applying SCAN Five Service Principles. Educate members, family, friends, providers and caregivers regarding benefits and plan options. Follow up with members by clarifying the customer's issue, determine the cause, and identify and explain solutions. Escalate appropriate member issues to management or other departments as required. Consistently meets and/or exceeds the departmental standards, including, but not limited to: quality, productivity, and adherence to schedule and attendance. Respond appropriately and in a timely fashion to members/internal staff/ and providers by answering telephonic and written inquiries concerning benefits, eligibility, referrals, claims and all other issues while following departmental policies and procedures and job aids. Follow up on issues, focusing on providing solutions and options for member, as necessary through resolution of member issue. Increases member satisfaction by following up and resolving member issues, complaints, and questions in an efficient, timely and accurate fashion; coordinates resolution with providers and other departments as needed. Follow all appropriate Federal and State regulatory requirements and guidelines applicable to SCAN Health Plan operations, as documented in company policies and procedures. Follow all HIPAA requirements. Documents transactions by completing applicable member forms and summarizing actions taken in appropriate computer system and following standards set by the department or by other authorized individuals.


Member Services, Call Center, Healthcare, Customer Service, Bilingual Spanish, Insurance, benefits, enrollment, eligibility, Bilingual, Spanish, Health Insurance, Health Plan

Top Skills Details:

Member Services, Call Center, Healthcare, Customer Service, Bilingual Spanish

Additional Skills & Qualifications:

MUST HAVE: High School diploma or equivalent required. 1 - 2 years call center or related customer service experience, required 1 - 2 years of prior experience with Medicare benefits, including Medicare Advantage Plans preferred. Hours during training: 8-4:30 PM (Mon-Fri) After training: 8 AM - 8 PM (Mon-Sun) - must be available to work weekends + any shift Bilingual candidates must pass testing to qualify for $1 pay increase

Experience Level:

Entry Level

About Aston Carter:

At Aston Carter, we're dedicated to expanding career opportunities for the skilled professionals who power our business. Our success is driven by the talented, motivated people who join our team across a range of positions - from recruiting, sales and delivery to corporate roles. As part of our team, employees have the opportunity for long-term career success, where hard work is rewarded and the potential for growth is limitless.

Established in 1997, Aston Carter is a leading staffing and consulting firm, providing high-caliber talent and premium services to more than 7,000 companies across North America. Spanning four continents and more than 200 offices, we extend our clients' capabilities by seeking solvers and delivering solutions to address today's workforce challenges. For organizations looking for innovative solutions shaped by critical-thinking professionals, visit AstonCarter.com. Aston Carter is a company within Allegis Group, a global leader in talent solutions.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email astoncarteraccommodation@astoncarter.com (%20astoncarteraccommodation@astoncarter.com) for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.

Keywords: Aston Carter, Ontario , Member Services Associate, Other , Ontario, California

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