We are in need of an influential Member Services Representative to join our collaborative team at Health New England in Springfield, MA.
Growing your career as a Full-Time Member Services Representative is a promising opportunity to develop exceptional skills.
If you are strong in teamwork, presentation and have the right personality for the job, then apply for the position of Member Services Representative at Health New England today!
SUMMARY: The Member Services Representative provides superior customer service to members, providers, and employer groups.
ESSENTIAL FUNCTIONS:
- Responds to inquiries from members, providers, and employer groups, providing superior product and benefit information for multiple HNE plans
- Researches and resolves complex member inquiries via telephone, member mail, e-mail and fax
- Educates members, employers and providers regarding benefits, policies, and procedures
- Meets individual and departmental standards
- Researches and resolves complex pharmacy issues utilizing the Reclaims system and the HNE Pharmacy Services Department
- Performs New Member Outreach Calls
- Processes member transactions, including but not limited to PCP changes, demographic changes, ID card requests and membership material requests
- Collaborates with Enrollment, Claims, Health Services, Pharmacy, Legal, and Sales to ensure that member issues are appropriately resolved
- Adheres to all regulatory requirements relating to member confidentiality, documentation, quality, and inquiry response time
MINIMUM REQUIREMENTS:
Associates degree and at least two years of customer service/call center experience within the managed care, insurance, or related call center industries or an equivalent combination of education and experience.
- Demonstrated listening and customer service skills
- Very good verbal and written communication skills
- Multi-tasking and detail oriented skills
- Problem resolution skills
- Very good interpersonal and negotiation skills
- Good organizational ability
- PC knowledge - preferably with the Microsoft suite of products
WORKING CONDITIONS: Works in a standard office-based environment
- Irregular Schedule - Occasionally (1/4 - 2 1/2 hrs.)
Benefits of working as a Member Services Representative in Springfield, MA:
● Company offers great benefits
● Room for Advancement
● Competitive salary
No CV Required
How to get there?
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