Member Services Representative

INTEGRA MLTC, INC. – Lake Success, NY

Bilingual Preferred

General Purpose/Scope:

The Member Services Representative triages inbound calls and provides first call resolution for all calls to Integra.

Responsibilities:

  • Provide call center coverage as needed and first call resolution
  • Coordinates with members, vendors and providers to ensure timely delivery of quality in-home services that are aligned with members service plans
  • Develops and maintains effective working relationships with members, families, advocates, service providers, and all members of the care management team
  • On an ongoing basis, monitors and ensures the timely execution and delivery of services to members, ensuring there are no lapses in service
  • Maintains and updates member records with pertinent information as necessary
  • Handles member, vendor, and provider requests for information and member materials
  • Obtains MD Orders, prescriptions, forms and all other documentation necessary from members and providers to ensure good quality service
  • Procures missing documentation as needed and ensures that all required documentation is present, complete, and accurate in Care Compass
  • Mails/Faxes documentation to members and vendors as needed (Care Plan, NOAs, CDPAP forms).
  • Fields member and provider telephone calls, responding to inquiries and resolving information requests
  • General office duties such as sorting mail, faxing, scanning, filing, updating and printing documents
  • All other duties and responsibilities as assigned
  • Qualifications:

  • Highschool diploma required, preferred Bachelors Degree
  • Minimum of two years of administrative experience
  • Knowledge of Health Care Organizations, Home Care and/or Long Term Home Care Agencies
  • Knowledge of Medicaid/Medicare eligibility requirements and MLTC processes and regulatory requirements
  • High volume in-bound out-bound call experience
  • Skills/Abilities:


  • Demonstrated ability to organize, problem solve and complete tasks within designated time frames
  • Self-starter with high level of accountability and responsibility
  • Excellent written, verbal, and interpersonal communication skills
  • Exemplary customer service skills
  • Highly organized and able to effectively manage multiple priorities
  • Bilingual ability a plus
  • Ability to multitask
  • Proficient in Microsoft Word & Excel a plus
  • Licenses/Certifications:

  • Customer Service Certification a plus
  • Integra is an Equal Opportunity Employer and Prohibits Discrimination and Harassment of Any Kind. Integra is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment. All employment decisions at Integra are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, sex, sexual orientation, gender identity, national origin, veteran or disability status, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. Integra will not tolerate discrimination or harassment based on any of these characteristics. Integra encourages applicants of all ages.

    If this opportunity sounds exciting and challenging to you, please click Apply now!

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