Member Services Agent
Company: Southern Scripts
Location: Nashville
Posted on: April 7, 2026
|
|
|
Job Description:
Member Services Agent Role and Responsibilities The member
services agent is responsible for providing effective customer
service for all internal and external customers by using excellent,
in-depth knowledge of company products and programs as well as
communicating effectively with team members within the customer
service department. * Knowledge of principles and processes for
providing customer and personal services. This includes customer
needs assessment, meeting quality standards for services, and
evaluation of customer satisfaction. Confer with customers by
telephone to provide information about Rx claims processing. * Keep
detailed records of customer interactions or transactions,
recording details of inquiries, complaints, or comments, as well as
actions taken. * Follow-up to ensure that appropriate changes were
made to resolve customers' problems. * Refer unresolved customer
grievances to designated departments for further investigation. *
Review Rx insurance policy terms to determine whether a claim is
covered for employer group. * Contact customers to respond to
inquiries or to notify them of claim investigation results or any
planned adjustments. * Resolve customers' service or billing
complaints. * Obtain and examine all relevant information to assess
validity of complaints and to determine possible causes. * Abide by
all obligations under HIPAA related to Protected Health Information
(PHI). * If a HIPAA violation is discovered, whether individually
or by another, you must report the violation to the Compliance
Officer and/or Human Resources. * Attend, complete, and demonstrate
competency in all required HIPAA Training offered by the company. *
Flexibility to understand, appreciate and embrace that this job
description is not designed to cover or contain a comprehensive
listing of activities, duties or responsibilities that are required
of the employee. Duties, responsibilities and activities may change
or new ones may be assigned at any time with or without notice.
Required Skills and Competencies * Interacting with Computers —
Using computers and computer systems (including hardware and
software) to program, write software, set up functions, enter data,
or process information. * Communicating with Supervisors, Peers, or
Subordinates — Providing information to supervisors, co-workers,
and subordinates by telephone, in written form, e-mail, or in
person. * Getting Information — Observing, receiving, and otherwise
obtaining information from all relevant sources. * Communicating
with Persons Outside Organization — Communicating with people
outside the organization, representing the organization to
customers, the public, government, and other external sources. This
information can be exchanged in person, in writing, or by telephone
or e-mail. * Processing Information — Compiling, coding,
categorizing, calculating, tabulating, auditing, or verifying
information or data. * Resolving Conflicts and Negotiating with
Others — Handling complaints, settling disputes, and resolving
grievances and conflicts, or otherwise negotiating with others. *
Updating and Using Relevant Knowledge — Keeping up-to-date
technically and applying new knowledge to your job. * Organizing,
Planning, and Prioritizing Work — Developing specific goals and
plans to prioritize, organize, and accomplish your work. *
Performing Administrative Activities — Performing day-to-day
administrative tasks such as maintaining information files and
processing paperwork. * Making Decisions and Solving Problems —
Analyzing information and evaluating results to choose the best
solution and solve problems. * Customer and Client Focus. * Problem
Solving and Analysis. * Time Management. * Communication
Proficiency. * Teamwork Orientation. * Technical Capacity. *
Multitasking Position Type and Expected Hours of Work This is a
full-time, hourly position. Days and hours of work vary on shift
assigned. The Call Center hours of operation are Monday - Friday 6a
- 10p, Saturday 8a - 6p, and Sunday 8a-5p. On-Call responsibilities
are on a rotation basis. Travel Minimal travel expected for this
position to Natchitoches, Louisiana for training and development.
Qualifications and Education Requirements * High School or
equivalent. * Customer service experience. * Computer experience.
Liviniti, LLC and all entities provides equal employment
opportunities (EEO) to all employees and applicants for employment
without regard to race, color, religion, sex, national origin, age,
disability, or genetics. In addition to federal law requirements,
Liviniti complies with applicable state and local laws governing
nondiscrimination in employment in every location in which the
company has facilities. This policy applies to all terms and
conditions of employment, including recruiting, hiring, placement,
promotion, termination, layoff, recall, transfer, leaves of
absence, compensation and training. Liviniti expressly prohibits
any form of workplace harassment based on race, color, religion,
gender, sexual orientation, gender identity or expression, national
origin, age, genetic information, disability, or veteran status.
Improper interference with the ability of Liviniti employees to
perform their job duties may result in discipline up to and
including discharge. EOE M/F/V/D PI41729b5cfdb8-29400-40118224
Keywords: Southern Scripts, Monroe , Member Services Agent, Customer Service & Call Center , Nashville, Louisiana