Contact Center Representative

This is responsible customer service work consisting primarily of responding to and resolving employee benefit, coverage, eligibility and claims inquiries related to medical, prescription, dental, life, disability, HRA and FSA coverages from Member Groups and Enrollees. This customer service is primarily provided telephonically in a call center environment, although email and secure portal messages are also a key avenue for delivering exceptional service. This position routinely provides administrative support in order to maintain service levels and a fully cross-trained team. As needed, the employee works with vendors, internal staff and references numerous resources, including vendor websites and government sources. The employee must maintain confidentiality at all times and must comply with internal policies and external regulations, including the Health Insurance Portability and Accountability Act (HIPAA).

Employee must possess detailed knowledge of the various coverage options and health management programs offered by HealthTrust, enrollment procedures and rules, and billing processes, which includes maintaining a strong level of knowledge regarding internal processes and, when applicable, government regulations. Appropriate follow-up, where warranted, is undertaken by the employee and generally consists of answering basic to complex inquiries, assisting with claim inquiries and reviewing and correcting problem situations. The employee exercises initiative, resourcefulness, ownership, judgment, and tact in working with Covered Individuals, Member Groups, and other HealthTrust employees in order to resolve inquiries and determine correct courses of action. The employee performs the position’s regular duties with little daily guidance. The Contact Center Assistant Manager or the Benefit Services Manager is consulted when problems of an unusual nature are encountered or patterns of issues are identified.

Essential Duties & Responsibilities

1. Provides exceptional customer service by responding to telephonic and written inquiries from Covered Individuals, Retirees, Member Groups, vendors, and others relating to enrollment, benefits, services, claims, billing, and administrative procedures for various employee benefit programs offered by HealthTrust. Maintains the secure message center Contact Center boxes as well as the email boxes. Completes detailed, concise and accurate documentation of all inquiries in the contact tracking database.

2. Explains HealthTrust’s various benefit programs and options (medical, dental, prescription drug, life, LTD, STD, FSA, HRA, and various wellness programs) to Member Groups, Covered Individuals, including Retirees. Utilizes internal resources as needed to deliver accurate and up to date information.

3. Responsible for resolving calls and messages that come into the team with a high level of customer satisfaction. Transfers issues to subject matter experts, when appropriate, and handles a wide variety of HealthTrust inquiries. Skills utilized to accomplish this generally consists of investigating, analyzing, and correcting problem situations. Identifies patterns of inquiries and alerts management of these issues.

Contact Center voicemail, email, and secure portal messages to promptly respond to inquiries from Covered Individuals, Member Groups, and vendors.

4. Maintains a strong and up-to-date level of knowledge of the various benefit programs offered by HealthTrust and associated administrative practices. Creates, maintains and regularly updates procedure manuals and other resources related to the activities performed by Contact Center Representatives and promotes communication of changes to the team. Follows policies and procedures to ensure all appropriate administrative rules, underwriting guidelines, federal and state laws, and individual Group policy guidelines are applied.

5. Assists covered individuals with claim issues, works with providers, billing offices, and insurance carriers to resolve complaints and claims processing problems. Uses critical thinking and maintains ownership over issues to ensure that they are successfully resolved.

6. Assists other organizational staff with questions and education related to this position’s area of knowledge. Participates in User Acceptance Testing of system updates to ensure proper functionality.

7. Performs administrative support on a regular basis in order to ensure a fully functioning cross-trained team that is able to withstand volatility in workload or changes in available resources.

8. Works closely with vendors to ensure that their enrollment database is up-to-date and accurate. Has the ability to view enrollment and claims information for Anthem, Delta and CVS Caremark.

9. Facilitates credit card transactions for COBRA, Retiree, and Benefit Advantage payments.

10. Supports HealthTrust’s educational efforts by reinforcing key messaging during Member Group and Covered Individual interactions as directed by the organization. Assists with basic Member Group trainings, including Benefit Administrator overview training sessions. Assists with newsletter articles on subject matter related to this position.

11. Performs special projects and other related duties or activities as required

Minimum Requirements:

Possession of an Associate’s degree is preferred, ideally with course work in information processing, insurance, or a similar field. Prior work experience of at least two years in responsible customer service work is required, preferably in the field of health insurance, claims processing, or information processing. The employee must also demonstrate proficiency in computerized data entry and word processing. Possession of additional education or specialized courses/training in insurance, underwriting, or information processing is highly desired. The position requires a high level of initiative, critical thinking, and organizational abilities.

In lieu of the above, any equivalent combination of training and experience that provides the above referenced knowledge, abilities, and skills may be considered at the discretion of HealthTrust.

This position is classified as hourly (non-exempt). Must be a New Hampshire resident. This position will start in the office for 12 weeks and then transition to Hybrid. To apply, email a résumé with cover letter to: hr@healthtrustnh.org

EOE

In addition to competitive salaries, HealthTrust provides a family-friendly work environment and offers excellent benefits including health, dental, and vision plans; life insurance; short-term and long-term disability insurance; a defined benefit pension plan and a deferred compensation plan; flexible spending accounts; and an on-site fitness center.

Job Type: Full-time

Pay: $43,000.00 - $47,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Shift:

• 8 hour shift

Work Location: In person

Salary : $43,000 - $47,000