Member Services Representative Interview Questions

1,803 member services representative interview questions shared by candidates

The role play questions were the hardest ones. A member calls wanting to see an out of network physician and is very adamant about seeing this doctor. You have to explain to the patient that this doctor does not participate with the insurance and ultimately he/she will be responsible for the payment of the visit. You have to offer the member an in network doctor to see that has good ratings. The second role play was about a member who received an unexpected bill for a laboratory test. Oscar pays for preventive service at no cost to the member, but insurance only covers routine lab work. You have to explain to the member that the extra test is not covered by the insurance and direct them to the laboratory and the doctor's office to try and resolve the issue.
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Member Service Representative

Interviewed at Oscar Health

2.9
Nov 24, 2015

The role play questions were the hardest ones. A member calls wanting to see an out of network physician and is very adamant about seeing this doctor. You have to explain to the patient that this doctor does not participate with the insurance and ultimately he/she will be responsible for the payment of the visit. You have to offer the member an in network doctor to see that has good ratings. The second role play was about a member who received an unexpected bill for a laboratory test. Oscar pays for preventive service at no cost to the member, but insurance only covers routine lab work. You have to explain to the member that the extra test is not covered by the insurance and direct them to the laboratory and the doctor's office to try and resolve the issue.

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