Member Service Advocate-27
$45,760–$45,760 year
On-siteCanton, Massachusetts, United States
Job Summary
Handle inbound calls from members addressing inquiries about health insurance benefits, coverage, claims, and eligibility. Navigate the healthcare system to resolve issues by providing education on Point32Health benefits and guiding members through self-service tools. Document all interactions accurately in the system while adhering to HIPAA and federal confidentiality standards. Execute outbound calls to improve member experience and support retention efforts. Collaborate with internal departments and external providers to ensure prompt issue resolution and seamless member experiences. Contribute to continuous improvement initiatives by providing feedback on member interactions and suggesting process enhancements.
Required Qualifications
- Associate degree or equivalent work experience
- 0-2 years of relevant experience
- Must be able to work under normal office conditions and work from home as required
- Must be able to work simultaneous use of a telephone/headset and PC/keyboard
- Must be able to sit for extended durations
- Must be able to work additional hours beyond standard work schedule
- Must have 100% attendance during training
- Knowledge of medical terminology
- Prior experience training and working in a virtual/remote setting
- Demonstrated ability to provide exceptional service, including active listening, empathy, and clear communication with members
- Ability to put yourself in someone else's shoes and demonstrate compassion
- Strong understanding of health insurance products, policies, and industry regulations, or the ability to quickly learn and apply new information
- Adept at identifying issues, analyzing information, and providing effective solutions in a timely manner
- Excellent verbal and written communication skills, with the ability to convey complex information clearly and professionally
- High level of accuracy in handling member information, processing requests, and documenting interactions
- Capable of managing multiple tasks simultaneously while maintaining focus and efficiency
- Comfortable using computer systems, CRM software, and other relevant technology to manage member interactions and data
- Ability to adjust to changing priorities and new processes in a dynamic work environment
- Strong people skills with the ability to work effectively with team members and contribute to a positive work atmosphere
- Skilled in managing and resolving conflicts and complaints with professionalism and patience
Desired Qualifications
- Bachelor's degree or equivalent work experience preferred
- Customer service experience in health care, call center or corporate office
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