DirectJobHub
Jobs · OTHR

Member Service Representative

Peak Health · Carolina, WV · 2 wk ago
RemoteRemoteOTHRFull-time

This position reports to the Manager of Member and Provider Services, playing a unique and important role in our mission to change healthcare for the better. Experience in the healthcare industry, critical thinking, and compassionate communication skills will help build an effective and efficient Membership Services Team.

About the role

The Membership Services Representative will take inbound calls from Peak Health members, answering questions ranging from general information to complex inquiries on a wide range of issues. This role will work with management and peers to research and resolve member issues and questions. In addition to taking inbound calls, the representative will make outbound calls to members for issue resolution or to gather further information. Ability to think critically and communicate effectively while following organizational policies and procedures is essential.

Responsibilities

  • Verify member information while addressing general questions.
  • Respond to and resolve all issues/inquiries to assure an efficient and seamless member experience.
  • Maintain open channels of member communications, conducting outreach as required.
  • Meet all production and quality standards, maintaining work queues according to department standards.
  • Effectively communicate with internal and external staff.
  • Elevate issues to the next level of supervision, as appropriate.
  • Ensure accuracy of information gathered and shared on a member’s behalf.
  • Attend all required training classes, demonstrating proficiency and ability to learn.
  • Maintain accurate documents, including timekeeping records.
  • Perform other duties as deemed appropriate by the Management Team.

Requirements

Minimum Qualifications

  • High School diploma or GED.
  • Two (2) years of customer service experience in a call center environment.

Preferred Qualifications

  • Associate Degree or greater in a related healthcare field.
  • Two or more years of experience in a fast-paced call environment with processing and/or customer service experience.

Physical Requirements

  • Ability to sit for extended periods of time.
  • Ability to answer phone calls for extended periods of time.
  • Lifting 10-25 lbs.
  • Travel requirement: 0%-25%.

Working Environment

The work environment is a standard office setting with electrical equipment such as telephone, personal computer, copier, and fax machines. Computer software/systems include Microsoft Office Professional Suite (Outlook, Word, Excel, Access), Internet Explorer, and EPIC.

Skills and Abilities

  • Working knowledge of administrative and clerical procedures and systems, such as word processing and managing files and records.
  • Ability to take direction and navigate through multiple systems simultaneously.
  • Excellent written and oral communication, customer service, interpersonal skills, and telephone etiquette.
  • Ability to solve problems using predefined methods and guidelines to drive improved efficiencies and customer satisfaction.
  • Familiarity with medical insurance services processes.
  • Exceptional attention to detail, organizational skills, and ability to perform multiple tasks simultaneously.
  • Ability to work remotely, requiring reliability, self-motivation, focus, and time management skills.
  • Ability to communicate clearly, concisely, and articulately while being an astute listener.

Schedule

Scheduled weekly hours: 40. Shift: Day. Non-exempt position.

Similar jobs