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Fallon Health Member Services Representative in Amherst, NY, New York


Fallon Health Vaccination Requirements:

To protect the health and safety of our workforce, members and communities we serve, Fallon Health now requires all employees to disclose COVID-19 vaccination status. As of 2/1/2022, all roles not designated as “Remote” require full COVID-19 vaccination and Fallon Health will obtain the necessary information from candidates prior to employment to ensure compliance. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

About Fallon Health

Founded in 1977, Fallon Health provides health care services designed to meet the unique and changing needs of all we serve. Fallon Health is the only health plan in Massachusetts that is both an insurer and provider of care, and we perform both of these roles with great care and consideration, consistently ranked among the nation’s top health plans.

It takes a special person to work at Fallon Health. We take great pride in matching each person with the role that fits best. Our dedicated professionals are united by compassion for the people we help, each contributing to our unique and innovative approach to health care.

Fallon Health Weinberg-MLTC:

Fallon Health Weinberg-MLTC is a partnership between Fallon Health of Massachusetts and Weinberg Campus of Erie County, New York. Fallon Health Weinberg a Managed Long Term Care (MLTC) is a plan to serve the health needs of dual-eligible residents of the Western New York counties of Erie and Niagara. Fallon Health Weinberg expands the choices that residents of Erie and Niagara Counties have when it comes to high quality, affordable health care.


To provide the members of the managed long term care insurance assistance as needed with benefits, authorizations, communications and support.


Job Responsibilities:

  • Responsible for coordinating services with providers, authorizations while working with care managers, members and providers for support.

  • Processing and tracking enrollment and disenrollment documents, to include submissions to outside agencies as needed.

  • Maintaining logs and reports

  • Responsible for compiling and maintaining member information

  • Establishes and maintains a system for inventory control of medical supplies.

  • Answering telephones, taking messages, and directing calls.

  • Utilizes Word, Excel, Access and PowerPoint proficiently

  • Enhances the program’s professional image through courteous, cooperative, and knowledgeable interactions with all individuals both internal and external while representing Fallon Health Weinberg

  • Other duties as assigned



  • High School Diploma

  • Associates Degree-preferred




  • Two (2) to three (3) years experience in an office setting, preferably in the health care industry.

  • Knowledge of medical terminology

  • Customer service experience preferred

  • Organizational skills required

  • Experience with Health Insurance/Medicaid—Preferred

  • Excellent computer skills required, including Windows, Word, Excel,

  • Excellent communication and organizational skills.

  • Ability to complete multiple tasks simultaneously.

  • Ability to work with people from various socio-cultural backgrounds in an effective manner.

  • Ability to work independently.

  • Has full and complete access to member information and reports where utmost integrity is required to safeguard member and/or program and, which if disclosed, would have adverse effects.

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Location US-NY-Amherst, NY

Posted Date 2 weeks ago (5/13/2022 2:34 PM)

Job ID 6857

# Positions 1

Category Customer Service