Customer Service Representative

6 hours ago

Springfield, Massachusetts, United States Health New England Full time
Job Summary

We are seeking a highly skilled and customer-focused Member Services Representative to join our team at Health New England. In this role, you will provide exceptional service to our members, providers, and employer groups, ensuring their needs are met and exceeded.

Key Responsibilities
  • Respond to inquiries from members, providers, and employer groups, providing accurate and timely information about our health plans and benefits.
  • Research and resolve complex member inquiries, utilizing your problem-solving skills and knowledge of our products and services.
  • Educate members, employers, and providers about our benefits, policies, and procedures, ensuring they have a clear understanding of their options.
  • Collaborate with internal teams, including Enrollment, Claims, Health Services, Pharmacy, Legal, and Sales, to ensure member issues are resolved efficiently and effectively.
  • Adhere to all regulatory requirements, maintaining confidentiality, accuracy, and quality in your work.
Requirements
  • Associate's degree and at least two years of customer service or call center experience in the managed care, insurance, or related industries.
  • Demonstrated listening and customer service skills, with the ability to communicate effectively in person, via phone, and in writing.
  • Multi-tasking and detail-oriented skills, with the ability to prioritize tasks and manage multiple projects simultaneously.
  • Problem resolution skills, with the ability to analyze complex issues and develop effective solutions.
  • Interpersonal and negotiation skills, with the ability to build strong relationships with members, providers, and internal stakeholders.
Working Conditions

This role requires a standard office-based environment, with occasional irregular schedules and varying work hours.

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