Customer Service Representative | Earn As Much As 25K | 10K Signing Bonus

Summary
The Member Services Representative assists plan members with their concerns or complaints and provides the necessary information and education to resolve concerns.
Essential Duties and Responsibilities
1. Explain the plan’s procedures, protocols, benefits, services, and any other necessary information to the members who telephone or visit the Member Services Department.
2. Facilitate member requests for changes with network provider changes, transportation requests, or any other member request for assistance as appropriate.
3. Answer all incoming member phone calls within the department’s goal timeframe.
4. Document every incoming call during the course of the call with pertinent details (i.e., caller name, contact info, reason for call, action taken, resolution, etc.,)
5. Respond to complaints against the health plan and its contracted facilities by utilizing the departments Complaint/Grievance Policy and Procedure.
6. Make all attempts to resolve all member disenrollment/cancellation requests, complaint/grievances, and assist the member with their questions or concerns and following up as appropriate.
7. Assist with Member Outreach programs and implementations as needed.
8. Foster good corporate relations by practicing good customer service principles (i.e., positive attitude, helpful, etc.).
9. Perform other duties as assigned by Department Management.
Qualifications
1. Above-average english communication skills
2. With atleast 1 year BPO/Call Center experience
3. Preferably with Healthcare account background in a BPO/Call Center setting
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