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Sr. Member Services Rep - HPHC Product

Company: TalentBoost (Point32Health)
Location: Somerset
Posted on: November 26, 2022

Job Description:

Are you interested in becoming part of a dynamic team that is looking to innovate and improve? -Would you like to work for a company that has been rated by the BBJ (15+yrs) as one of the best places to work?Do you want to be part of a company that is committed to giving back to the community?Point32Health/ Harvard Pilgrim Health Care is currently seeking highly motivated individuals to join our organization as Sr. Member Service Rep. The Sr. Member Services Rep provides best-in-class service to all constituents, including but not limited to members, prospective members, employers, providers/pharmacists, vendors, and internal Harvard Pilgrim staff, to build customer loyalty, extend customer retention, and satisfy corporate goals and objectives.WHAT YOU WILL BE DOING:

  • Receives and responds to a high volume of incoming calls. Provides accurate and thorough information on HPHC benefits, eligibility and enrollment policies to members, prospective members and internal customers.
  • Receives and responds to online secure messages from members via the online portal and Wellframe phone application dashboard.
  • May interact in person directly with members and employer group representatives.
  • Maintains thorough understanding of HPHC's policies, products and systems. Answers product billing, enrollment, and eligibility questions for all traditional products, including continuation of coverage and COBRA.
  • Protects member privacy and confidentiality by consistently maintaining full compliance with all HIPAA regulations.
  • Understands and relays information regarding contract riders, member programs, and all HPHC vendor relationships. -
  • Captures and documents customer feedback; receives, resolves, and routes complaints; accurately handles appeals process inquiries and consults with appropriate staff when required. -
  • Perform out-of-the-box thinking, collaborate with others, and make a difference every day!
  • Other duties and projects as assigned.WHAT YOU NEED:
    • High school diploma
    • Minimum of 1-2 years of customer service experience in a managed care environment is required. Experience with HPHC Member Services (call-center environment) strongly preferred.
    • Time Management skills.
    • Strong verbal and written communication skills.
    • After training, schedule will be rotating Monday to Friday: 8:00am-4:30pm, 11:30am-8pm
    • Experience that demonstrates your ability to be resilient, collaborative, flexible, innovative.WHAT MAKES US STAND OUT -
      • Work-Life-Flexibility
      • Paid volunteer time off (up to 3 days annually)
      • Open Time Off (include for exempt positions only)
      • Annual Mini-Grant of $500 donated to a non-profit organization of the employee's choice
      • Educational ReimbursementWhat 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 Us:Point32Health 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, we're 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.Req ID: -R4782

Keywords: TalentBoost (Point32Health), Fall River , Sr. Member Services Rep - HPHC Product, Sales , Somerset, Massachusetts

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