Member Service Representative

Shrewsbury, MA 01545

Post Date: 07/18/2018 Job ID: 3262347 Industry: Customer Service Representative

Under the general direction of the Call Center Supervisor, the Member Services Representative is responsible for providing accurate and thorough interpretation of healthcare benefits, claims processes, eligibility, and enrollment policies to members. 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 objectives.

  • Receives and responds to a high volume of incoming telephone calls from members, prospective members, employers.
  • Makes necessary outgoing phone calls to resolve member related inquiries.
  • Meet or exceed department established key performance indicators.
  • Adheres to assigned schedules to ensure appropriate phone queue coverage.
  • Employs active listening skills, demonstrates patience and empathy, and is able to handle difficult customers tactfully, courteously and professionally.

  • High School Diploma or equivalent required. Associates degree or equivalent work experience preferred.

  • 6-12 months of relevant experience.
  • Preferred customer service experience in health care, call center, retail, hospitality or corporate office.
  • Knowledge of medical terminology is preferred.

  • Must have strong computer and telephone multitasking skills
  • Must have the ability to navigates through multiple systems
  • Accuracy in data input and documentation
  • Strong written and oral communication skills

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