Member Services Representative at The Ohio State University in Columbus, Ohio

Job Description:

Screen reader users may encounter difficulty with this site. For assistance with applying, please contact hr-accessibleapplication@osu.edu. If you have questions while submitting an application, please review these frequently asked questions.

Current Employees and Students:If you are currently employed or enrolled as a student at The Ohio State University, please log in to Workday to use the internal application process. Welcome to The Ohio State University's career site. We invite you to apply to positions of interest. In order to ensure your application is complete, you must complete the following:

• Ensure you have all necessary documents available when starting the application process. You can review the additional job description section on postings for documents that may be required.


• Prior to submitting your application, please review and update (if necessary) the information in your candidate profile as it will transfer to your application.

Job Title:Member Services RepresentativeDepartment:OSU Health Plan | Customer Service

Scope of Position

Responsible for serving as a liaison between members, providers, third-party vendors, and the university. Assists with member complaints, documents and corrects claims questions and problems, assists with medical benefit questions and explains medical benefits, schedules all screenings and educational programs, and other queries. Assists providers and third-party vendors calling on providers' behalf with authorization information, insurance eligibility and benefits, verification of coverage, including CPT and diagnosis codes, out-of-pocket, deductible accumulations and how benefits are processed.

Position Summary

Works in a team environment to provide member service and resolve all Tier 1 calls (routine calls regarding medical plans, processes and procedures); answers provider/member phone calls in a timely and accurate manner; produces mail/electronic correspondence; provides general information on benefits and services; documents inquiries in tracking systems to ensure quality service; inputs data for case management and correspondence databases; researches pending claims and refers them on with recommendations for processing; researches and resolves complaints; maintains working knowledge of The Ohio State University Health Plan Inc. service departments and triages member inquiries to appropriate experts within OSUHP; works on special projects and provides administrative support as assigned. Requires successful completion of a background check(s).

Minimum Qualifications

• 
  

  One to three years of member service experience

  
  


• 
  

  Knowledge of Microsoft Office required

  
  


• 
  

  Knowledge of medical benefits and managed care policies

  
  


• 
  

  Previous working experience with automated/computerized call center phone systems desired

  
  

Our Comprehensive Employee Benefits Include

• 
  

  An array of retirement plan options, each with a generous employer contribution.

  
  


• 
  

  Affordable health insurance options, including dental, vision and prescription coverage that begin on day one.

  
  


• 
  

  Paid vacation and sick leave, including short and long-term disability and paid parental leave.

  
  


• 
  

  Get the most out of the Public Service Loan Forgiveness program.

  
  


• 
  

  And much more!

  
  

Additional Information:Location:Ackerman Rd, 700 (0921)Position Type:RegularScheduled Hours:40
Shift:First Shift

Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.

Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions.

The Ohio State University is an equal opportunity employer.

All qualified applicants will receive consideration for employment without regard to age, ancestry, color, disability, ethnicity, gender identity or expression, genetic information, HIV/AIDS status, military status, national origin, race, religion, sex, gender, sexual orientation, pregnancy, protected veteran status, or any other basis under the law.

Applicants are encouraged to complete and submit the Equal Employment Identification form.

Apply Now