To respond to member and provider issues and inquiries. Ensures that callers' questions and/or problems are resolved or are directed to the appropriate person for resolution and provides the highest level of customer service. Responsibilities Responds to member and provider issues and questions received in the member services queue. Documents calls as appropriate. Escalates calls to Lead Member Services Representative or Member Services management, as needed. Works with internal departments, pro... more details
Member Services Representative
Job LocationsUS-CA-Fairfield | US-CA-Redding
Job ID
2024-3040
FLSA Status
Non-Exempt
Hiring Range
$ 24.02 - $ 27.62
Overview
To respond to member and provider issues and inquiries. Ensures that callers’ questions and/or problems are resolved or are directed to the appropriate person for resolution and provides the highest level of customer service.
Responsibilities
Responds to member and provider issues and questions received in the member services queue.
Documents calls as appropriate.
Escalates calls to Lead Member Services Representative or Member Services management, as needed.
Works with internal departments, providers, and external organizations to resolve issues as needed.
Reviews all incoming e-mails to ensure compliance with instructions that impact processes and/or benefits that impact members.
Processes enrollment duties as assigned.
Enters data in relevant online systems.
Other duties as assigned.
Qualifications
Education and Experience
High school diploma or equivalent; minimum one (1) year Call Center experience in a MCO setting and/or working with the public in a service environment, preferred; previous customer service or call center experience preferred.
Special Skills, Licenses andCertifications
Excellent verbal and written communication skills, ability to relate and connect with callers, good phone voice, patience, good problem resolution skills and the ability to show empathy when appropriate. Enjoys assisting callers and working with the public in sometimes stressful situations. Ability to de-escalate angry callers. Bi-lingual in Spanish may be required.
Performance Based Competencies
Typing 25 wpm.
Work Environment And Physical Demands
More than 50% of work time is spent using a headset, keyboard and multiple computer monitors.
All HealthPlan employees are expected to:
Provide the highest possible level of service to clients;
Promote teamwork and cooperative effort among employees;
Maintain safe practices; and
Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.
HIRING RANGE:
$ 24.02 - $ 27.62
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.
Job Abstracts is an independent Job Search Engine. Job Abstracts is not an agent or representative and is not endorsed, sponsored or affiliated with any employer. Job Abstracts uses proprietary technology to keep the availability and accuracy of its job listings and their details. All trademarks, service marks, logos, domain names, and job descriptions are the property of their respective holder. Job Abstracts does not have its members apply for a job on the jobabstracts.com website. Additionally, Job Abstracts may provide a list of third-party job listings that may not be affiliated with any employer. Please make sure you understand and agree to the website's Terms & Conditions and Privacy Policies you are applying on as they may differ from ours and are not in our control.
We would like to take a second to Welcome You to Job Abstracts, the nation’s largest Pure Job Board. With over 3.1 million job listings from 15,000+ Companies & Organizations, we help job searchers find careers that match their interests. As an anonymous user, you have probably discovered how easy our system is to use. However, you have just scratched the surface of what we can offer.
We encourage you to Register so you can use our most powerful features: searching with multiple terms, setting up multiple locations, establishing favorite companies, and accessing your search history. If you find a job you like, you can apply directly for it, and then, keep notes on it. We will also keep a lookout for jobs that match your search terms and email you when we find something you may like.
You can register for free and the system is free to use. If you like our system so far, click on Register and unlock the power required by serious job searchers.
Any time you conduct a search, the system shows you job matches, ranked by their Relevance Score (RS).
The score is calculated by a proprietary algorithm that uses Intelligent Machine Learning.
The Relevance Score tells you how well the job opportunity matches your search term or terms.
When not logged in, the system is limited to one search term. Scores for single term matches are usually lower.
When you register, log in, and set up multiple terms prioritized by importance, the jobs found for you will receive a much higher Relevance Score.
