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Member Services Representative

Company: Elderwood Health Plan
Location: Tonawanda
Posted on: September 12, 2021

Job Description:

Join Our Team: Join our strong and growing company today! Overview:

Immediate opening for a Member Service Associate in Buffalo, NY!


Elderwood Health Plan is currently seeking a Member Service Associate to join our managed long-term care interdisciplinary (MLTC) team. This is a critical healthcare role as you serve as a main contact for our health plan members, which consists of 100% Medicaid paid services.


In this role, you are responsible for providing customer service and medical office assistance for the non-clinical aspects of our plan members’ person-centered plan of care. The person in this role will ideally understand the challenges and needs of the membership, in addition to having experience with using an EMR.


This is a great opportunity for someone who has worked in a primary care physicians office or a large hospital outpatient clinic.


Our Member Service Representatives (MSR) are responsible for the non-clinical aspects of an EW Health Plan members’ person-centered plan of care and will serve as the primary point of contact for members. An important part of this role is maintaining a high level of professionalism and establishing a rapport with every member


Other tasks include:

  • Assisting with Member concerns
  • Handling Member inquiries
  • Completing necessary authorizations and triaging calls to the necessary team
  • Interacting/partnering with other departments including claims, intake, enrollment, and provider services to resolve member and provider issues
  • Assisting the Care Management Team with the following:
    • discharge preparation
    • request clinical information
    • arranging transportation
    • coordinating medical supply delivery
    • creation of authorizations within electronic medical record
  • Participating in special projects as assigned, such as Disease Management, Utilization Management, and Quality Improvement activities
  • Identifying barriers to member care and elevating awareness of Member or Provider need and collaborating with team to develop solutions
  • High School Diploma or equivalent; an associate degree preferred
  • Minimum one (1) year experience within an MLTC or Health Care setting
  • Minimum of one (1) year experience working with a diverse and medically fragile population
  • Proficient computer skills, including working knowledge of Microsoft 365 and electronic medical record (EMR)



  • Customer Service Orientation
  • Discretion
  • Excellent verbal & written communication skills
  • Managing through systems
  • Multi-tasking
  • Organization
  • Patience
  • Problem solving and analytical thinking
  • Trustworthiness
  • Teamwork & Cooperation


Elderwood expects all current and new employees to be vaccinated against COVID-19. If hired, you will be required to provide proof of vaccination. Employees may request a medical exemption from vaccination.



Employee Perks!: 401K Retirement Plan with Company Match, Clean, Neat & Newly Renovated Facility, Close to thruway entrances/exits, Conveniently located on a bus route, Enjoy a fun and diverse work environment, Enjoy being a part of a strong and diverse team, Free On-Site Parking, Generous PTO & holiday package, Life Insurance, Medical, Dental, and Vision insurance, Point-earning employee reward program: redeem for prizes!, Relaxing employee lounge with free iced/hot coffee, Strong leadership, Substantial employee referral program EOE Statement: WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Keywords: Elderwood Health Plan, Tonawanda , Member Services Representative, Other , Tonawanda, New York

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