Member Services Representative Resume Samples

A Member Services Representative renders support and services to the membership-based organization’s clients. A well-drafted Member Services Representative Resume indicates the following duties – responding to requests and complaints; making sales, processing orders, providing information about the organization and its related services; responding instantly to the needs and concerns of the clients; investigating and resolving complaints and concerns; processing transactions; recommending and cross-selling products and services; and escalating unresolved issues to higher authorities or members.

Those seeking to work in this area of work should focus on the following – excellent verbal and written communication skills; strong interpersonal skills; basic personal computer skills, prior sales experience, familiarity with saving and checking products, customer service skills and bilingual speaking skills. A high school diploma or GED is the necessary requirement. However, advanced education will be helpful.

Member Services Representative Resume example

Member Services Representative Resume

Objective : An aspiring team worker, hardworking, and dedicated individual who wants to meet the challenges posed in the industry and to contribute towards the growth of the organization along with self-motivation. Seeking new challenges in a progressive organization with opportunities for advancement.

Skills : Microsoft; Word, Excel, PowerPoint, Access, National Customer Service Certified

Member Services Representative Resume Model

Description :

  1. Educated members and providers on health plan initiatives during telephone conversations.
  2. Maintained performance and quality standards based on established call center metrics including turn-around times.
  3. Reported on membership trends, marketing effectiveness and member feedback to the executive director.
  4. Improved call center functionality and service capacity by resolving customer complaints efficiently and quickly.
  5. Performs a broad variety of duties to service customers on the banking floor and to promote and cross-sell bank services.
  6. Takes and prepares consumer and home equity loan applications, reviewing the credit report for further cross-selling opportunities.
  • Provided clear and concise answers to member questions and inquiries to ensure quality customer experience.
  • Years of Experience
    Experience
    0-2 Years
    Experience Level
    Level
    Entry Level
    Education
    Education
    Marketing


    Member Services Representative I Resume

    Objective : To provide superior customer service while being as friendly and helpful as possible. Meet the needs of the customer and assist them in any questions they might have. Looking to join a suitable organization that rewards hard work and offers good opportunities for career development.

    Skills : Sales, Training, Leadership, Research, Operations, Financial Services, Customer Service, Banking, Communication, Teamwork, Tellers, Spectrum, BranchSuite, Origins, Microsoft Office

    Member Services Representative I Resume Template

    Description :

    1. Answer incoming calls from pharmacies, physicians, & members of Medicaid, Medicare, Va, worker's compensation & the public sector.
    2. Actively listen to the caller, determine the reason for the call, & document information in the system.
    3. Assist callers with inquiries regarding benefits, such as eligibility, copay, deductible, formulary, etc.
    4. Assist members with mail order requests, such as new registration, prescription refills, order status, etc.
    5. Accommodate mail order billing issues, including invoice inquiries, past due balance, credit card payment.
    6. Troubleshoot rejected insurance claims and advise the caller of resolution for paid claims.
    7. Coordinate internal resolution of claims exceptions, including possible overrides.
    8. Assist physician's offices with determining if the medication requires prior authorization, or has plan limitations.
    Years of Experience
    Experience
    2-5 Years
    Experience Level
    Level
    Executive
    Education
    Education
    Computer Networking


    Lead Member Services Representative Resume

    Summary : Self-motivated sales professional with over 8 years of management, training, and customer service experience. Possess excellent strategic planning and relationship management skills to expand customer brand awareness and improve retention. In addition to proven track record in successfully introducing new products into a competitive market with the ever-changing needs of both our business and customers.

    Skills : Microsoft Office, Excel, Word, Outlook, Customer Service, Customer Relationship Management

    Lead Member Services Representative Resume Template

    Description :

    1. Essential duties and responsibilities is to greet members, prospective members, and guests, providing exceptional customer service.
    2. Advised clients on products that would best suit their needs responded to clients regarding account information; performed problem resolution.
    3. Respond to member questions and concerns in a timely and professional manner and elevate to assistant manager or manager as needed.
    4. Assisted providers, Medicaid and Medicare members on benefits issues, claims inquiries, and eligibility verifications.
    5. Provided customer service to all inbound calls as well as making outbound/outreach calls daily.
    6. Assist members and other departments to research errors and member issues.
    7. Comfort providing customer service with clients over the phone handling multi-line phone operation in a call center environment.
    Years of Experience
    Experience
    7-10 Years
    Experience Level
    Level
    Management
    Education
    Education
    Computer Science

    Member Services Representative II Resume

    Summary : To contribute my enthusiastic personality and excellent clerical skills for medical records or related position in a clinical setting Qualifications. Over 15 years of experience providing quality customer service and excellent relationship building and leadership abilities. Effective problem identification resolution skills.

    Skills : Medical Coding, Goverment Claims Processing, Denial Management, Patient Access, Medical Terminology, Medical Billing Exp, Claims Adjuster, Pharmacy Techician

    Member Services Representative II Resume Example

    Description :

    1. Currently acting as a liaison between the Medicare member services department and pharmacy services department.
    2. Assisting with pharmacy-related escalations that require significant research, often out of the scope of knowledge for an MSR.
    3. Actively assisting with providing pharmacy training to a newly hired class of representatives.
    4. Actively assisting with drafting communications to be the sent to the entire department regarding changes/improvements to pharmacy processes.
    5. Contact various ipa's on the members' behalf to check the status of referrals and authorizations.
    6. Work directly with provider relations to ensure that providers reflect active eligibility on all platforms.
    7. Perform manual updates on all platforms to ensure claims are properly paid.
    8. Curated and lead up training for various topics for the department in order to increase agent knowledge and productivity.
    9. Traveled to different affiliated offices within the organization to be uptrained on different products and system enhancements.
    Years of Experience
    Experience
    10+ Years
    Experience Level
    Level
    Senior
    Education
    Education
    Diploma

    Business Member Services Representative Resume

    Objective : To utilize my skills and experience in Collections and Medical Billing and Insurance coding in the Health Care Industry, giving me an opportunity for growth and advancement. 3+ years of customer service experience, passionate about quality customer service,

    Skills : Microsoft Office, Management, Customer Service Representative, Janitorial, Excel, Power point, Word, Aircraft Towing, Forklift Operator.

    Business Member Services Representative Resume Example

    Description :

    1. Developed and maintained relationships and negotiations with vendors, Costco managers, and related departments, for the benefit of the members' resolution.
    2. Resolved outcomes for members, & issued compensations necessary due to the resolutions.
    3. Drafted correspondence to members/vendors regularly, and kept copies of all correspondences for Costco files, and members records.
    4. Coordinated relocations for traveling members discontent with their accommodations or resort experience.
    5. Determined and coordinated pricing adjustments in these scenarios, including monetary resolutions on revolving files.
  • Proactively handled member needs with the highest level of customer service.
  • Maintained vault and cash drawer and conducted all teller transactions for members.
  • Years of Experience
    Experience
    0-2 Years
    Experience Level
    Level
    Junior
    Education
    Education
    Sociology

    Member Services Representative II Resume

    Summary : Over 9 years of responsible corporate experience as an Administrative/ Front Office assistant with experience in customer relations, scheduling,and general office operations. Strong organizational abilities combined with excellent interpersonal, and communication skills that allow me to work effectively with other people at all levels.

    Skills : High Customer Service Standards, Working Knowledge Of Microsoft Word And Excel, Has Excellent Verbal And Written Communication .

    Member Services Representative II Resume Sample

    Description :

    1. Described products to members and accurately explained details and care of merchandise.
    2. Answered product questions with up-to-date knowledge of credit union products and promotions.
    3. Effectively communicated with and supported administrative team on a daily basis.
    4. Developed a reputation as an efficient member services representative with high levels of accuracy.
    5. Investigated and resolved member inquiries and complaints in a timely and empathetic manner.
    6. Ensured superior customer experience by addressing member concerns, demonstrating empathy and resolving problems on the spot.
    7. Built long-term relationships and advised members on purchases and promotions.
  • Assisting supervisor and manager with taking calls escalated from another rep.
  • Years of Experience
    Experience
    7-10 Years
    Experience Level
    Level
    Management
    Education
    Education
    Medical Assistant

    Lead Member Services Representative Resume

    Headline : Dedicated professional with a proven track record in managing multiple, concurrent projects with strong problem solving and follow-through capabilities. Demonstrated ability to work under pressure and meet tight deadlines. Effective leadership, critical thinking, problem solving and interpersonal skills.

    Skills : Customer Service, Microsoft Office Programs, Academic Research, Social Media Marketing

    Lead Member Services Representative Resume Model

    Description :

    1. Handles phone calls which will vary from problems and complaints to inquiries and questions for all aspects of the business and will originate from various sources including the members, doctor's offices, hospital offices, and outside vendors.
    2. Evaluates phone calls for possible forwarding to the supervisor depending on the nature of the call.
    3. Makes suggestions to members for more efficient services available to them through the use of more compatible doctor offices, hospitals, pharmacies, dentists and/or vision centers.
    4. Exerts best effort to retain members who are calling to dis-enroll from membership.
    5. Communicates effectively with other staff members in the resolution of problem, complaint and inquiry phone calls.
    6. Enters appropriate data in various computer programs in an efficient and accurate manner.
    7. Verifying insurance for doctor offices and hospitals, provider calls referrals and authorization status and claims.
  • Maintained customer records, data, and files for retention and other administrative duties.
  • Years of Experience
    Experience
    5-7 Years
    Experience Level
    Level
    Consultant
    Education
    Education
    Diploma

    Member Services Representative Resume

    Objective : Guest Relations Customer Service Professional with a true desire to satisfy the needs of others in a fast pace environment, 3 years of customer service experience, successful with conflict resolution in a professional manner, consistent quality assurance recognition, and perfect attendance.

    Skills : Proficient In Microsoft Windows, Claims Administration System,telphone, Fax Machines, Kiosk, Carelink, And Matrix Systems.

    Member Services Representative Resume Template

    Description :

    1. Utilized the experience and developed communication skills, to explain confusing and complicated topics in a manner that allows for complete understanding.
    2. Answering inbound calls, using experience in customer service and sound listening skills, choose the effective scripting quickly for excellent member service.
    3. Fraud detection representative o exercised discretion and good judgment while making sound business decisions and analyzing system records in very limited time.
    4. Handle product inquiries, while maintaining company standards and ensuring member satisfaction.
    5. Utilized effective communications to explain confusing and complicated topics in a clear and concise manner.
    6. Verified account activity and take appropriate action to minimize potential fraud loss and member inconvenience while maintaining call control.
    7. Extensive research and documentation of every call to follow-up on customer inquiries.
    Years of Experience
    Experience
    2-5 Years
    Experience Level
    Level
    Executive
    Education
    Education
    Medical Billing

    Member Services Representative Resume

    Summary : Looking forward towards a responsible position where can effectively utilize skills from prior experience, while enhancing my knowledge and enabling me to make a positive and productive contribution in a long term career. Acknowledged for accuracy and efficiency as a Data Entry Clerk.

    Skills : Technical Computer , Word, Inventory Management, Low Level Management

    Member Services Representative Resume Template

    Description :

    1. Manage member care expenditures such as medical supplies, nurse's services, and social worker visits.
    2. Resolved member care issues, problems, and concerns provided accurate and timely response to a high volume of member and prospective member calls.
    3. Assist supervisor with the special project including member acquisitions and payment authorization.
  • Assisted leadership personnel in the mentoring and skill building of new employees.
  • Participated in various escalation projects under leadership supervision and direction.
  • Gathered and verified all required customer information for tracking purposes.
  • Referred unresolved customer grievances to designated departments for further investigation.
  • Provided accurate and appropriate information in response to customer inquiries.
  • Years of Experience
    Experience
    10+ Years
    Experience Level
    Level
    Senior
    Education
    Education
    Bachelor of Science

    Member Services Representative Resume

    Summary : Enthusiastic professional, with expertise in inventory control and project coordination. Excellent team player with proven ability to multitask and capacity build. Extensive background in customer satisfaction, planning and evaluations, coaching, and communication.

    Skills : Customer Service, Customer Relationship Management, Administrative Support, Insurance, Teamwork

    Member Services Representative Resume Sample

    Description :

    1. Answered questions related to accounts including balances, payoffs, and online banking.
    2. Recognized selling opportunities and effectively sold/cross-sold bank products and services.
    3. Educate members and staff on how to properly use and research the mobile deposit software.
    4. Answer inbound calls from state Medicaid members/prospects in regards to enrollment, claims, and benefits.
    5. Document customer requests and inquiries in call history database and ensure timely closure of all open issues.
    6. Complete contract forms, prepare change of address records, or issue service discontinuance orders, using computers.
    7. Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.
  • Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments.
  • Years of Experience
    Experience
    10+ Years
    Experience Level
    Level
    Senior
    Education
    Education
    Degree