TRANSFORMING HEALTHCARE, ONE MEMBER AT A TIMEWhat we build together changes our customer's health for the better. We are looking for talented and innovative people to join our team. Come join us!WHAT MAKES US STAND OUT…

Here at Point32Health our member services representatives are the backbone of the company. The value we place on our reps is at the highest level. Our representatives are our brand ambassadors and our members are taken care of everyday, because of this. WHAT YOU’LL RECEIVE…

The experience and organizational knowledge you’ll gain as a member services representative serves as a flexible foundation for growth across the enterprise. You’ll receive paid training, career development and advancement opportunities, and a generous benefits package that includes paid time off, paid volunteer time off (up to 3 days annually), educational reimbursement, a company 401k match, medical benefits and more! Full Time, Remote Position (must reside in CT, DC, FL, GA, IL, IN, IA, MA, ME, MD, MN, NC, NH, NJ, NY, OH, PA, RI, SC, TX, VT or WA.)

$19.00/hr. ($39,520 annually) quarterly incentives after trainingClass start date: 7/22/2024

Key Responsibilities/Duties – what you will be doing

WHAT YOU’LL DO… 

In this role, you are responsible for providing accurate and thorough interpretation of Point32Health benefits, claims processes, eligibility, and enrollment policies to members, employers, and internal customers. You will seek resolution of complex customer inquiries, the facilitation of problem resolution, and meeting or exceeding customers’ expectations.

This role is equally challenging and rewarding. Within a high-volume environment, you’ll need to model and act as an ambassador for the company while solving complex health care inquires and a customer advocate to resolve escalated and complex issues. Undoubtedly the best part is that you'll be helping people every single day, while making a positive impact on their life. This role allows you to nurture your desire to help others and earn a living at the same time.

Specific responsibilities

• Managing a high volume of incoming telephone calls from members, prospective members, employers, and internal Point32Health staff.
• Efficiently and effectively processing calls. This includes:
  • Accessing the information and proficiently resolving the concern.
  • Asking probing questions, while educating to reduce repeat calls.
  • Accurately documenting the complete encounter.
  • Investigating complaints and performing front-line analysis and intervention.
  • Making necessary outgoing phone calls to resolve member related inquiries.
• Following assigned schedules to ensure appropriate phone queue coverage.
• Interacting and forming contacts with other Point32Health departments to resolve issues.
• Participating in initiatives and responding to requests for help.
• Engaging in opportunities to mentor new colleagues and assisting with department projects.
• Other ad hoc duties as needed.
• Achieving key performance indicators.

Qualifications – what you need to perform the job

WHAT YOU’LL NEED…

• High School Diploma or equivalent (hiset or GED) required; College degree preferred.

• 6 months of work experience (customer service, retail, hospitality, or healthcare setting preferred).
• Knowledge of medical terminology is a huge plus.
• Prior experience training and working in a completely virtual and remote setting is a plus.
• A desire to work in a professional environment.

Technical Skills:

• Proficiency with MS Windows and basic computer literacy.
• Strength in accurate data entry and documentation.
• Ability to navigate through multiple systems simultaneously.
• Ability to multitask effectively.

Interpersonal Skills:

• Active listening skills (practices patience and empathy, and can handle difficult customers tactfully, courteously, and professionally).
• Comfortable speaking to people about potentially difficult or very personal and highly sensitive, emotional topics.
• Excellent verbal skills (communicates clearly and articulately).
• Strong written skills (takes accurate and comprehensive notes).
• Ability to exercise discretion and maintain confidentiality.
• Ability to work cooperatively as part of a team, and part of a larger organization.
• Ability to work under pressure and manage changing priorities with consistent professionalism.

WORKING CONDITIONS

• This is a fast-paced environment handling multiple demands and exercising appropriate judgment as necessary.
• Requires a high level of initiative and independence.
• Involves simultaneous use of a telephone headset, and PC/keyboard for long periods.
• Requires long periods of sitting and occasional overtime may be requested.
• May require ability and willingness to work from home.
• Must adapt positively to changes related to work processes, department structure, environment, and technology.

REMOTE REQUIREMENTS

• Remote work requirements include a quiet and confidential setting.
• 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. (Hot spots and Wi-Fi will not be supported)

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.

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities.

This job has been posted by Ignyte AI on behalf of Point32Health. Ignyte AI is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of Ignyte AI not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.