Member Services Representative I

Job Details Job Location Smithfield, RI - Smithfield, RI Remote Type Fully Remote Position Type Full Time Education Level High School or GED   Travel Percentage None Job Shift Daytime Job Category Entry Level Description The Member Service Representative I should possess a genuine desire and commitment to assist members and support the mission, vision and values of Neighborhood. He/she is the most junior level call center service representative who is responsible for telephonically working with members.
Duties and Responsibilities
Responsibilities include, but are not limited to the following:
Answers a high volume of calls from members and pharmacies
Use active listening skills, demonstrate patience and empathy, and is able to handle difficult customers courteously and professionally
Research, review and respond to all entry-level inquiries that are received through incoming calls, e-mail or written correspondence
Meet or exceed department established key performance indicators
Adheres to assigned schedules to ensure appropriate phone queue coverage
Employs active listening skills, demonstrates patience and empathy, and is able to handle difficult customers tactfully, courteously and professionally.
Interacts with other internal departments to resolve issues
Provides accurate documentation regarding the inquiry in the Customer Service Call Tracking Applications
Uses knowledge of Neighborhood organizational structure, Member Services workflow and operating procedures to resolve members issues
Works effectively in a team environment
Represents Neighborhood to internal and external customers in a professional manner
Assists with completion of projects/programs as necessary
Perform other assigned tasks as needed
Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhoods Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents

Qualifications Qualifications
Required:
High school degree or equivalent
Minimum of one (1) year phone and/or customer service experience
Attention to detail
Excellent written/communication skills
Strong listening skills
Beginner/Intermediate proficiency on MS Windows
Demonstrated ability to navigate multiple systems

Preferred:
Managed care experience
Knowledge of Neighborhood organizational structure, Member Services workflow and operating procedures
Strong organizational skills
Knowledge of Member Services Service Levels and NCQA/HIPAA Standards
Proficient in handling the Medicaid lines of business
Bilingual

Flexible Work Arrangement:
Candidates must be able and flexible to start work on any given day between 8am and 10am Monday through Friday and to work an 8.0 hour shift, which includes hour uninterrupted unpaid meal break

Telecommuting Arrangement:
This position works 100% remote and is assigned to a Permanent Remote Team. The training is in-person and will last about 6 weeks. Occasional in-person days may be required.

Training Dates (Monday-Thursday in-person, Friday remote)
Start Date 6/24/2024
End Date 7/29/2024 (this is a tentative date and is subject to minor change)

Neighborhood is an Affirmative Action and Equal Opportunity Employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, genetic information, age, disability, veteran status or any other legally protected basis.