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Member Services Representative, HPHC Commercial

Company: Point32Health
Location: Providence
Posted on: June 24, 2022

Job Description:

TRANSFORMING HEALTHCARE, ONE MEMBER AT A TIMERemote Position (must reside in MA, RI, NH, CT, ME)Full Time$19.00/hr. ($39,520 annually) + monthly incentives after trainingWHAT MAKES US STAND OUTHere at Point32Health our member service representatives are the backbone of the company. Our members are taken care of everyday because of this. The value we place on our reps is at the highest level.

  • PAID 8/10-WEEK TRAINING (June 21 - August 26)
  • Work-Life-Flexibility
  • Paid volunteer time off (up to 3 days annually)
  • Educational ReimbursementWHAT YOULL DOJob SummaryUnder the general direction of the Call Center Supervisor, the Member Services Representative is responsible for providing accurate and thorough interpretation of Point32Health benefits, claims processes, eligibility, and enrollment policies to members, employers, and internal customers. In addition, the Member Services Representative is responsible for resolution of complex customer inquiries, the facilitation of problem resolution, and meeting or exceeding customers expectations. The Member Services Representative presents a consistent and professional demeanor to all callers and internal customers and is expected to identify opportunities to improve customer service and efficiency. The Member Services Representative is expected to take responsibility for every interaction with a customer by providing outstanding service as a means to build customer loyalty, improve customer retention, and satisfy corporate customer service goals and objectives.Job Description
    • Receives and responds to a high volume of incoming telephone calls from members, prospective members, employers, and internal Point32Health staff.
    • Efficiently and effectively processes member calls. This includes:
      • Accesses the most appropriate source of information and proficiently resolving the members concern.
      • Accurately documents the complete encounter and maintains a professional and supportive attitude throughout the call.
      • Asks probing questions and takes the opportunity to educate members to avoid unnecessary repeat calls.
      • Investigates member complaints and performs front-line analysis and intervention when appropriate.
      • Makes necessary outgoing phone calls to resolve member related inquiries.
      • Meet or exceed department established key performance indicators.
      • Adheres to assigned schedules to ensure appropriate phone queue coverage.
      • Demonstrates strong written (e.g., documents calls accurately and comprehensively) and verbal skills.
      • Employs active listening skills, demonstrates patience and empathy, and is able to handle difficult customers tactfully, courteously and professionally.
      • Strives for improved efficiency for processing member issues.
      • Interacts and forms contacts with other Point32Health departments in order to resolve issues.
      • Participates in initiatives and/or responds to requests for help to contribute to team and department success.
      • Assists in mentoring new staff as directed.
      • Assist with department projects as needed.RequirementsWHAT YOULL NEEDEDUCATION:
        • High School Diploma or equivalent required. Associates degree or equivalent work experience preferred.EXPERIENCE:
          • 6-12 months of relevant experience.
          • Preferred customer service experience in health care, call center or corporate office.
          • Knowledge of medical terminology is preferred.
          • Prior experience training and working in a virtual/remote setting is strongly preferred.SKILL REQUIREMENTS: Technical Skills:
            • Must have strong computer and telephone multitasking skills
            • Must have the ability to navigates through multiple systems
            • Accuracy in data input and documentation
            • Proficiency with MS Windows
            • Proficient keyboard skillsInterpersonal Skills:
              • Excellent verbal and written communication skills are required
              • Strong organizational skills
              • Ability to research and respond to a high volume of telephone inquiries in a consistent and professional manner
              • Basic math, grammar, and spelling are required
              • Ability to work under pressure and with attention to changing priorities
              • Must be able to work cooperatively as part of a team
                • Fast paced office environment handling multiple demands exercising appropriate judgment as necessary.
                • Requires a high level of initiative and independence and communication skills sufficient to communicate verbally via telephone.
                • Must adapt positively to changes related to work processes, department structure, environment, and technology.
                • Involves simultaneous use of a telephone headset, and PC/keyboard for long periods of time in order to document and communicate efficiently.
                • Requires long periods of sitting and occasional overtime may be requested.
                • May require ability and willingness to work from home.CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Point32Heal is considered confidential. Will be exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy and department guidelines/policies and all applicable laws and regulations at all times.What we build together changes our customer's health for the better. We are looking for talented and innovative people to join our team. Come join us!Please note: As of January 18, 2022, all employees including remote employees must be fully vaccinated. This position will require the successful candidate to show proof of full vaccination against COVID-19. Point32Health is an equal opportunity employer, and will consider reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law. About UsPoint32Health is a leading health and wellbeing organization, delivering an ever-better health care experience to everyone in our communities. Building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.At Point32Health, were working to reshape the world of health care by pushing past the status quo and delivering even more to the diverse communities we serve: more innovation, more access, more support, and healthier lives. And we want people like you on our side to make it even better.This job has been posted by TalentBoost on behalf of Point32Health. TalentBoost is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of TalentBoost not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.

Keywords: Point32Health, Providence , Member Services Representative, HPHC Commercial, Sales , Providence, Rhode Island

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