Member Services Representative II
Company: UHealthSolutions Inc
Location: Shrewsbury
Posted on: March 19, 2023
Job Description:
Member Services Representative II
UHealthSolutions is seeking candidates for several full-time
positions within various programs within the Contact Center. These
programs are designed to provide outbound and inbound call center
services.
Position Summary:
The Member Services Representative II is primarily responsible for
resolving general inquiries from customers utilizing subject matter
expertise and available resources. UHealthSolutions provides these
services 24 hours per day, 365 days per year for a variety of
clients. Therefore, this position requires a particular emphasis on
reliability and flexibility in work schedules and assignments in
order to ensure that we meet contractual obligations across all
operating hours.
Primary Responsibilities:
- Resolve inbound and outbound contacts in accordance with
established program policies, procedures, and standards
- Provide customers with comprehensive assistance in obtaining
access to benefits from a broad array of insurers, payors,
providers and advocacy groups
- Perform administrative functions, including but not limited to
review of enrollment applications and documentation
- Utilize provided scripts and procedures to provide customers
with general information and exercise reasonable judgment to
appropriately transfer / escalate more complex issues to the
appropriate location for resolution
- Perform basic administrative functions, including but not
limited to filing, scanning of documents
- Demonstrate consistent and professional customer service
skills: active listening, ability to engage the customer,
appropriate utilization of resources, clear written and verbal
communication
- Adhere to scheduled shift and break times
- Log all contacts in accordance with established program
policies, procedures, and standards Employee Responsibilities
- Achieve minimum productivity and quality standards for each
task assigned
- Actively participate in quality control/quality improvement
initiatives
- Participate in knowledge transfer / side-by-side "buddy"
training, as directed
- Attend and participate in meetings and training as
directed
- Maintain the confidentiality of all business documents and
correspondence according to HIPAA, corporate, and program
guidelines
- Comply with established departmental policies, procedures and
objectives
- Comply with all health and safety regulations and requirements
Supervision Received:
Reports to Designated Contact Center Supervisor
Position Qualifications:
- High school diploma or equivalent
- Must read, speak and write English fluently
- Bi-lingual proficiency preferred (Must read, speak and write
Spanish fluently)
- Must have at least 6-12 months of relevant experience in health
care, call center, retail, hospitality, or corporate office.
Knowledge of health care terminology is preferred.
- Physical ability to stand and repetitively bend down and reach
up for extended periods of time (e.g., for file room projects)
- Must be flexible regarding hours scheduled (e.g., morning,
mid-day, evenings, overnight, weekends, and holiday assignments)
Skills:
- Ability to comprehend and communicate regarding complex program
subject matter in order to resolve inquiries from callers in a
timely and accurate manner
- Ability to write narrative documentation of customer
interactions using appropriate spelling, grammar, punctuation and
professionalism
- Ability to utilize customer service skills including the
ability to relate well to diverse populations and to represent the
organization professionally
- Sound judgment and discretion
- Ability to communicate clearly and effectively verbally and in
writing
- Accurate typing/data entry and information tracking skills at a
minimum proficiency of 40 words per minute
- Computer literacy including experience with Internet Browsers,
Microsoft Outlook, Word, and Excel COVID-19 Considerations:
- All employees must show proof of vaccination or seek exemption
or accommodation related to disability, medical or religious based
reason(s) by their 1st day of employment.
The above statements are intended to describe the general nature
and level of work being performed. They are not intended to be an
exhaustive list of all responsibilities, duties and skills required
of personnel so classified. UHS reserves the right to modify
position duties at any time, due to business necessity.
UHealthSolutions is an equal opportunity employer and encourages
applications from individuals with varied experiences and
backgrounds .
UHealthSolutions is a Tobacco-Free Workplace.
Keywords: UHealthSolutions Inc, Worcester , Member Services Representative II, Other , Shrewsbury, Massachusetts
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