Member Experience Representative I
2 weeks ago
Network Health's success is rooted in its mission to create healthy and strong Wisconsin communities. It drives the decisions we make, including the people we choose to join our growing team.
Our Member Experience Representative I will support our Medicare line of business with benefit interpretation, claims, authorizations and other member inquiries in a collaborative, innovative environment. The person in this role will support our members through their healthcare questions via customer calls and e-mails or help providers with answering questions about our Network Health plans.
Our Member Experience Representative promotes our "Service Excellence" value by helping members navigate their healthcare needs by explaining their benefits, solving claim concerns, finding a doctor in their area, or being their healthcare provider support. At Network Health we strive to bring a better healthcare experience and ensure that members only need to call once to get the help they need.
Job Responsibilities
- Support our Network Health members by answering calls and proactively work to resolve our members questions and concerns.
- Strive for first call resolution, working to resolve member issues at the point of contact.
- Use dual monitors while leveraging computer-based resources to find answers to customers questions and help simplify next steps for members.
- You may reach out to internal departments or external resources to help resolve a member concern.
- We provide a continuous learning environment where you can learn and stay current with our plans, computer systems, and insurance trends.
- You will have the ultimate responsibility of protecting the personal health information of our members.
Requirements
- High school diploma or equivalent
- Strong desire to help others
- Previous experience in the insurance industry is a plus
- Medical terminology background is a plus
- Excellent communication skills including the ability to clearly explain complicated subjects
- Warm and pleasant demeanor over the phone. We want our members to hear your smile
- The ability to work in several computer systems and multi-screen set-up and know where to find answers
We strive to provide amazing service in plain language that our members will understand. The initial training period is a 6-8 week program with a work schedule of Monday - Friday from 8:00am - 4:30pm. After your training, you can select a Monday - Friday work schedule of either 8:00am to 4:30pm or 8:30am to 5:00pm.
Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both in our hybrid workplace model.
We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce.
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