Member Services Representative

1 week ago

Canton, Massachusetts, United States Ignyte AI Full time
Job Description

Transforming Healthcare, One Member at a Time

We are seeking a highly skilled and dedicated Member Services Representative to join our team at Point32Health. As a key member of our organization, you will play a vital role in providing exceptional customer service and support to our members, employers, and internal customers.

Key Responsibilities:

  • Provide Accurate and Thorough Interpretation of Benefits: Interpret and explain Point32Health benefits, claims processes, eligibility, and enrollment policies to members, employers, and internal customers.
  • Seek Resolution of Complex Customer Inquiries: Resolve complex customer inquiries, facilitate problem resolution, and meet or exceed customers' expectations.
  • Model and Act as an Ambassador for the Company: Model and act as an ambassador for the company while solving complex healthcare inquiries and advocating for customers.
  • Manage High-Volume Environment: Manage a high-volume environment, handling multiple demands and exercising appropriate judgment as necessary.
  • Work Cooperatively as Part of a Team: Work cooperatively as part of a team, and part of a larger organization, to achieve common goals and objectives.

Requirements:

  • High School Diploma or Equivalent: High school diploma or equivalent required; college degree preferred.
  • 6+ Months of Work Experience: 6+ months of work experience in customer service, retail, hospitality, or healthcare setting preferred.
  • Knowledge of Medical Terminology: Knowledge of medical terminology is a huge plus.
  • Prior Experience in Virtual and Remote Setting: Prior experience training and working in a completely virtual and remote setting is a plus.
  • Desire to Work in a Professional Environment: A desire to work in a professional environment.

Technical Skills:

  • Proficiency with MS Windows: Proficiency with MS Windows and basic computer literacy.
  • Strength in Accurate Data Entry: Strength in accurate data entry and documentation.
  • Ability to Navigate Multiple Systems: Ability to navigate through multiple systems simultaneously.
  • Ability to Multitask Effectively: Ability to multitask effectively.

Interpersonal Skills:

  • Active Listening Skills: Active listening skills, practicing patience and empathy, and handling difficult customers tactfully, courteously, and professionally.
  • Comfortable Speaking with Customers: Comfortable speaking to people about potentially difficult or very personal and highly sensitive, emotional topics.
  • Excellent Verbal Skills: Excellent verbal skills, communicating clearly and articulately.
  • Strong Written Skills: Strong written skills, taking accurate and comprehensive notes.
  • Ability to Exercise Discretion: Ability to exercise discretion and maintain confidentiality.
  • Ability to Work Cooperatively: Ability to work cooperatively as part of a team, and part of a larger organization.
  • Ability to Work Under Pressure: Ability to work under pressure and manage changing priorities with consistent professionalism.

Working Conditions:

  • Fast-Paced Environment: This is a fast-paced environment handling multiple demands and exercising appropriate judgment as necessary.
  • Requires High Level of Initiative: Requires a high level of initiative and independence.
  • Simultaneous Use of Telephone Headset and PC/Keyboard: Involves simultaneous use of a telephone headset, and PC/keyboard for long periods.
  • Long Periods of Sitting: Requires long periods of sitting and occasional overtime may be requested.
  • Ability to Work from Home: May require ability and willingness to work from home.
  • Adaptability: Must adapt positively to changes related to work processes, department structure, environment, and technology.

Remote Requirements:

  • Quiet and Confidential Setting: Remote work requirements include a quiet and confidential setting.
  • High-Speed Internet: Remote work requirements also include high-speed internet and direct ethernet connection. A minimum of 100 Mbps download speed and 10 Mbps upload speed is a good starting point.

Confidential Data:

All information (written, verbal, electronic, etc.) that an employee encounters while working at Point32Health 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.

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

Point32Health is committed to making diversity, equity, inclusion, accessibility, and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams, and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

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