{"id":3093470,"url":"https://alion.io/job/alliance-resource-partners-member-services-representative","title":"Member Services Representative","company":{"id":2371638,"name":"Alliance Resource Partners","domain":"arlp.com","url":"https://alion.io/company/arlp","size_band":"11-50","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Breezy","truth_index":null},"role":"HR","role_family":"HR","seniority":"junior","employment_type":"full_time","work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Tulsa, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":{"min_usd":38000,"max_usd":74000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":1805},"experience_years_min":1,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"HIPAA","optional":false},{"name":"Microsoft Office","optional":false}],"status":"live","first_seen_at":"2026-10-22T15:16:59Z","employer_posted_date":"2026-10-22","last_verified_at":"2026-10-25T01:11:28Z","board_verified":true,"closed_at":null,"days_open":2,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":2},"description":"Primary Responsibilities:\nThe Member Services Representative serves as a point of contact for health care plan participants (employees and dependents), company human resources representatives and providers regarding plan eligibility, plan services, benefits coverage, provider reimbursement, claims questions and processing. Receives and processes inbound correspondence and documentation including mail, email, faxes and delivery and, in turn, sorts, delivers and files according to established processes. Receives various medical records and other documentation and ensures that they are uploaded into electronic documentation system with correct naming convention, dispersing records to proper person/department. May also provide administrative support for Provider Contracting Departments and works closely with Care Coordination, Care Navigation, and Claims Teams.\nREPRESENTATIVE DUTIES AND RESPONSIBILITIES: The items listed below detail some of the assigned duties and responsibilities for this position. This is not meant to be an all-inclusive list, and management reserves the right to change these duties at any time.\nReceive, respond to and/or refer inbound employee, provider and physician documentation through fax, mail and email or other delivery methods.\nReceive, log, scan and route vital pieces of claim documentation including Refund Checks, Medical Records or other documents.\nAttach DCN numbers to claims and correspondence in various systems such as QC and document imaging system.\nTrack their receipt, electronically upload into correct intake coordinator folder or electronic record; maintain medical record archives.\nVerifies returned mail and makes necessary updates within applicable systems. \nPerforms daily Mail Merge letter report. Send out letters to correct providers and members via fax and US Mail as required.\nRetrieve & deliver departmental mail and outgoing correspondence.\nWork collaboratively with all HealthPlan Teams to ensure that best practices are identified and shared.\nWork with other departments to research and resolve their questions and concerns within scope of responsibility.\nIdentifies and escalates repetitive questions and/or problems so that corrective action can be pursued and expedited.\nPerform other projects and duties as needed.\nKnowledge and Skills Required\nOutstanding customer services skills.\nExcellent listening skills with the ability to interpret and understand underlying issues and unasked questions.\nFamiliarity with medical claims processing, denials and appeals process in a health care plan environment.\nKnowledge of health care customer service, Health Plan and regulatory requirements and provider dispute and/or member appeal process.\nKnowledge of CPT/HCPC, ICD9/10 coding, procedures and guidelines helpful.\nExcellent vocabulary, grammar, spelling, punctuation, and composition skills proven through the development of written communication.\nAbility to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA) and fraud and abuse prevention detection policies and procedures\nAbility to establish and maintain positive and effective working relationships with coworkers, plan members and providers.\nStrong computer skills and familiarity with Microsoft Office required and cloud-based file storage systems preferred.\nEducation and experience:\nAt least 1 years of experience in a healthcare or medical insurance customer service role with direct payment and provider contact preferred.","description_format":"text","description_chars":3507,"description_truncated":false,"requirements":{"experience_years_min":1,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[]},"benefits":["Health insurance"],"hiring_locations":[],"hiring_excludes":[],"relocation_offered":false,"industries":["Coal","Mining"],"lifecycle":[{"event":"open","at":"2026-10-22T15:34:34Z"}],"visa":[],"liveness":{"score":86,"band":"hot","label":"Hiring now","p_open":1,"p_active":0.86,"p_room":1,"age_days":1,"expected_fill_days":24,"reasons":["conf:3","win:early","comp:junior"],"computed_at":"2026-10-24T06:02:35Z"},"pay":null,"html_url":"https://alion.io/job/alliance-resource-partners-member-services-representative","json_url":"https://alion.io/job/alliance-resource-partners-member-services-representative.json","meta":{"generated_at":"2026-10-25T01:59:22Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":2978,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-26T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":2371638},"rest":"https://alion.io/mcp/rest/get_company?id=2371638"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Falliance-resource-partners-member-services-representative"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Falliance-resource-partners-member-services-representative"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Falliance-resource-partners-member-services-representative"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/alliance-resource-partners-member-services-representative\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Falliance-resource-partners-member-services-representative"}]}