What are the responsibilities and job description for the Member Services Representative position at Anasazi Medical Payment?
Job Description
Job Description
Description :
The Member Service Representative on our Customer Service and Support Team works directly with our members by answering calls, navigating software systems, responding to email inquiries, and collaborating internally to better resolve and understand member needs, issues, or concerns.
The Member Service Representative and Support Team acts as a full maintenance customer care center for our current and future members. The Member Service Representative is responsible for handling inbound calls from pharmacies, patients, doctor's offices, and more to resolve and document any technical issues, complaints, or suggestions. This role communicates predominantly on the phone and electronically with our customers to drive the efficient and effective savings solution for medications while keeping our internal team updated. You will use critical thinking skills and attention to detail to accurately determine the nature of the issue affecting the member. You will work to achieve success and smooth transitions for new members as well as continuing great service for our current customers. The goal of this position is to create the perfect experience for our members so they can relax and feel confident about their coverage through Drexi.
Job Responsibilities :
- Maintain confidentiality with respect to HIPAA guidelines.
- Provides a positive, high quality customer experience for members calling in regarding their coverage and to resolve any issues or concerns the member or pharmacy might be receiving.
- Utilizes technology and basic troubleshooting skills to determine the nature of the issue in our adjudication engine.
- Navigates multiple systems to identify the source of the issue.
- Properly documents and classifies member issues to ensure proper service and solutions are being implemented.
- Adheres with HIPAA standards and operational processes while working in a fast-paced environment.
- Achieves KPIs in a contact center-based production environment where productivity and quality are key in providing excellent customer experiences.
- Handles escalated callers constructively, constantly striving to provide positive outcomes for all our members.
- Manages real-time inquires while keeping track of and responding to commitments.
- Remains available on the phone to address all requests and customer questions.
- Provides information to supervisors and co-workers by instant messaging, phone calls, emails, or tickets.
- Demonstrates professionalism in communication, relationship development, customer service, etc.
- Shift flexibility will be required.
- Fosters a positive team environment.
- Ensure confidentiality and accuracy of internal and external data.
- Perform ad-hoc projects and other duties as assigned.
Requirements :
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