Member Services Representative, HPHC Commercial
Location: North Dighton
Posted on: June 22, 2022
TRANSFORMING HEALTHCARE, ONE MEMBER AT A TIMERemote Position
(must reside in MA, RI, NH, CT, ME)Full Time$19.00/hr. ($39,520
annually) + monthly incentives after trainingWHAT MAKES US STAND
OUTHere at Point32Health our member service representatives are the
backbone of the company. Our members are taken care of everyday
because of this. The value we place on our reps is at the highest
- PAID 8/10-WEEK TRAINING (June 21 - August 26)
- Paid volunteer time off (up to 3 days annually)
- Educational ReimbursementWHAT YOULL DOJob SummaryUnder the
general direction of the Call Center Supervisor, the Member
Services Representative is responsible for providing accurate and
thorough interpretation of Point32Health benefits, claims
processes, eligibility, and enrollment policies to members,
employers, and internal customers. In addition, the Member Services
Representative is responsible for resolution of complex customer
inquiries, the facilitation of problem resolution, and meeting or
exceeding customers expectations. The Member Services
Representative presents a consistent and professional demeanor to
all callers and internal customers and is expected to identify
opportunities to improve customer service and efficiency. The
Member Services Representative is expected to take responsibility
for every interaction with a customer by providing outstanding
service as a means to build customer loyalty, improve customer
retention, and satisfy corporate customer service goals and
- Receives and responds to a high volume of incoming telephone
calls from members, prospective members, employers, and internal
- Efficiently and effectively processes member calls. This
- Accesses the most appropriate source of information and
proficiently resolving the members concern.
- Accurately documents the complete encounter and maintains a
professional and supportive attitude throughout the call.
- Asks probing questions and takes the opportunity to educate
members to avoid unnecessary repeat calls.
- Investigates member complaints and performs front-line analysis
and intervention when appropriate.
- Makes necessary outgoing phone calls to resolve member related
- Meet or exceed department established key performance
- Adheres to assigned schedules to ensure appropriate phone queue
- Demonstrates strong written (e.g., documents calls accurately
and comprehensively) and verbal skills.
- Employs active listening skills, demonstrates patience and
empathy, and is able to handle difficult customers tactfully,
courteously and professionally.
- Strives for improved efficiency for processing member
- Interacts and forms contacts with other Point32Health
departments in order to resolve issues.
- Participates in initiatives and/or responds to requests for
help to contribute to team and department success.
- Assists in mentoring new staff as directed.
- Assist with department projects as needed.RequirementsWHAT
- High School Diploma or equivalent required. Associates degree
or equivalent work experience preferred.EXPERIENCE:
- 6-12 months of relevant experience.
- Preferred customer service experience in health care, call
center or corporate office.
- Knowledge of medical terminology is preferred.
- Prior experience training and working in a virtual/remote
setting is strongly preferred.SKILL REQUIREMENTS: Technical Skills:
- Must have strong computer and telephone multitasking
- Must have the ability to navigates through multiple
- Accuracy in data input and documentation
- Proficiency with MS Windows
- Proficient keyboard skillsInterpersonal Skills:
- Excellent verbal and written communication skills are
- Strong organizational skills
- Ability to research and respond to a high volume of telephone
inquiries in a consistent and professional manner
- Basic math, grammar, and spelling are required
- Ability to work under pressure and with attention to changing
- Must be able to work cooperatively as part of a team
- Bilingual preferred WORKING CONDITIONS AND ADDITIONAL
- Fast paced office environment handling multiple demands
exercising appropriate judgment as necessary.
- Requires a high level of initiative and independence and
communication skills sufficient to communicate verbally via
- Must adapt positively to changes related to work processes,
department structure, environment, and technology.
- Involves simultaneous use of a telephone headset, and
PC/keyboard for long periods of time in order to document and
- Requires long periods of sitting and occasional overtime may be
- May require ability and willingness to work from
home.CONFIDENTIAL DATA: All information (written, verbal,
electronic, etc.) that an employee encounters while working at
Point32Heal is considered confidential. Will be exposed to and
required to deal with highly confidential and sensitive material
and must adhere to corporate compliance policy and department
guidelines/policies and all applicable laws and regulations at all
times.What we build together changes our customer's health for the
better. We are looking for talented and innovative people to join
our team. Come join us!Please note: As of January 18, 2022, all
employees including remote employees must be fully vaccinated. This
position will require the successful candidate to show proof of
full vaccination against COVID-19. Point32Health is an equal
opportunity employer, and will consider reasonable accommodation to
those individuals who are unable to be vaccinated consistent with
federal, state, and local law. About UsPoint32Health is a leading
health and wellbeing organization, delivering an ever-better health
care experience to everyone in our communities. Building on the
quality, nonprofit heritage of our founding organizations, Tufts
Health Plan and Harvard Pilgrim Health Care, we leverage our
experience and expertise to help people find their version of
healthier living through a broad range of health plans and tools
that make navigating health and wellbeing easier.At Point32Health,
were working to reshape the world of health care by pushing past
the status quo and delivering even more to the diverse communities
we serve: more innovation, more access, more support, and healthier
lives. And we want people like you on our side to make it even
better.This job has been posted by TalentBoost on behalf of
Point32Health. TalentBoost is committed to the fundamental
principle of equal opportunity and equal treatment for every
prospective and current employee. It is the policy of TalentBoost
not to discriminate based on race, color, national or ethnic
origin, ancestry, age, religion, creed, disability, sex and gender,
sexual orientation, gender identity and/or expression, military or
veteran status, or any other characteristic protected under
applicable federal, state or local law.
Keywords: Point32Health, Fall River , Member Services Representative, HPHC Commercial, Sales , North Dighton, Massachusetts
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