| Job Title | Low range | Mid range | Hi range |
|---|---|---|---|
| Member Services Representative | $28,451 | $30,022 | $34,909 |
| Member Services Supervisor | $46,228 | $51,041 | $57,677 |
| Member Services Manager | $62,058 | $69,761 | $80,906 |
| Member Services Director | $102,655 | $118,428 | $132,871 |
Addresses member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for receiving, responding to, and directing member phone calls. Provides available information upon request and escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines. Requires a high school diploma or its equivalent and 2-4 years of related experience. Has knowledge of commonly-used concepts, practices, and procedures within a particular field. Relies on instructions and pre-established guidelines to perform the functions of the job. Works under immediate supervision. Typically reports to a supervisor or manager.
Addresses more complex member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for receiving, responding to, and directing member phone calls. Provides available information upon request and escalates issues as appropriate. Supervises hiring, ensuring effective training, ongoing monitoring and QA, evaluations and any disciplinary actions of member services representatives. Requires a high school diploma or its equivalent and 5-8 years of related experience. Familiar with a variety of the field's concepts, practices, and procedures. Relies on extensive experience and judgment to plan and accomplish goals. Performs a variety of tasks. Leads and directs the work of others. A wide degree of creativity and latitude is expected. Typically reports to a manager.
Responsible for all activities in the member services function for a heath maintenance organization (HMO). Continuously tracks membership and maintains a log of all information related to members. Requires a bachelor's degree in area of specialty and at least 5 years of experience in the field or in a related area. Familiar with a variety of the field's concepts, practices, and procedures. Relies on extensive experience and judgment to plan and accomplish goals. Performs a variety of tasks. Leads and directs the work of others. A wide degree of creativity and latitude is expected. Typically reports to a head of unit/department.
Directs and coordinates all aspects of the health maintenance organization (HMO) member services department. Tracks membership and maintains a log of all information related to members. May require an advanced degree and at least 10 years of direct experience in the field. Familiar with a variety of the field's concepts, practices, and procedures. Relies on extensive experience and judgment to plan and accomplish goals. Performs a variety of tasks. Leads and directs the work of others. A wide degree of creativity and latitude is expected. Typically reports to top management.