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Customer Service Representative, MI - Remote id-19318

We are looking for a Customer Service Representative, to join us in leading our organization forward.

McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of McLaren Health Care Corporation and is the parent company of McLaren Health Plan in Michigan and MDwise, Inc. in Indiana. MIG was founded in 2018 when MDwise, Inc. joined the McLaren family. MIG provides leadership, integration opportunities, oversight, direction and support to the McLaren health plans.

McLaren Health Plan and MDwise, Inc., subsidiaries of MIG, value the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plans can thrive.   As an employee MIG, 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.

McLaren Health Plan (MHP) a subsidiary of McLaren Integrated HMO Group, is a Health Maintenance Organization (HMO), dedicated to meeting the health care needs of each member. The HMO was started to serve Michigan's Medicaid population and has added individual and Medicare products along with a Third-Party Administrator called Health Advantage, Inc., the McLaren Employee Plan. 

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MDwise, a subsidiary of McLaren Integrated HMO Group, is an Indiana-based nonprofit health care company. MDwise was founded in 1994 to help vulnerable populations needing health coverage in Indiana. The mission is to provide high quality health care. MDwise only takes care of families in Indiana. MDwise works with the State of Indiana and Centers for Medicare and Medicaid Services to bring the residents of Indiana the Hoosier Healthwise and Healthy Indiana Plan health insurance programs. Learn more about MDwise, Inc. at https://www.mdwise.org/

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. 

This is a fully remote position.

Equal Opportunity Employer of Minorities/Females/Disabled/Veterans

Qualifications:
Required:

  • High School Diploma or equivalent certification;
  • One (1) year experience in a customer service related role with direct contact with customers via telephone, email, chat and/or face-to-face.

Preferred:

  • One (1) year experience in a physician health care office environment or high-volume call center.
  • One (1) year experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions.
Additional Information
  • Schedule: Full-time
  • Requisition ID: 25000949
  • Daily Work Times: 8:00 am - 8:00 pm
  • Hours Per Pay Period: 80
  • On Call: No
  • Weekends: No
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