Customer Service Representative

Corewell Health • Saint Joseph, MI

1d • Onsite

About The Position

This role is for an Inbound Call Center Customer Service Representative who will assist and educate members, employer groups, providers, colleagues, and/or agents regarding health plan benefits, accessing services, facilitating and resolving problems, and understanding claims, billing, and coding. The representative is expected to consistently create an exceptional experience through various contact methods including inbound and outbound calls, face-to-face interactions, online chat, and email. As a team member at Corewell Health, you will play an essential role in delivering personalized health care to patients, members, and communities. Corewell Health is committed to cultivating and investing in its team members, fostering a culture of collaborators, leaders, and innovators dedicated to improving health, instilling humanity, and inspiring hope. It is a nationally recognized health system with an ambitious vision for advancement and excellence. Corewell Health is a not-for-profit health system with over 60,000 dedicated people, including more than 11,500 physicians and advanced practice providers and over 15,000 nurses, providing care and services across 22 hospitals, 300+ outpatient locations, and several post-acute facilities. It also includes Priority Health, a provider-sponsored health plan serving over 1.2 million members. The organization is focused on reimagining a better, more equitable model of health and wellness through experience and collaboration.

Requirements

• High School Diploma or equivalent

Nice To Haves

• Associate's Degree
• 1 year of relevant experience in related field

Responsibilities

• Analyzes, evaluates, resolves and responds to service inquires from members, providers, employer groups, colleagues, agents, Elite agents (customers), and others within departmental guidelines.
• Professional and pleasant interactions are ongoing expectations.
• Partnering with internal and external resources, promptly provides customers with information and education concerning benefit clarification, eligibility requirements, verification, authorization, billing and claim status.
• Promptly identifies and resolves or escalates customer concerns or complaints to achieve positive outcomes.
• Places outbound welcome calls to members to educate them on their benefits as needed.
• Assists walk-in members and agents if assigned by leadership.
• Adheres to established procedure and quality guidelines in support of Priority Health service promise, key drivers, performance indicators, as well as Corporate values and codes of excellence.
• Identifies potential trends or issues that impact health plan members and works with coworkers and leadership resources to suggest process improvements.
• Assists members with administrative issues, such as submitting enrollment record changes, providing letter explaining coverage or benefits, and obtaining and relaying certain member information to other departments as needed.
• Facilitates claims resolution through follow-up on member calls and correspondence received to appropriate departments.
• Effectively tracks and/or documents all service interactions with customers within appropriate systems according to guidelines.
• Develops and maintains behaviors of productivity, availability to customers, and adherence to work schedule.

Benefits

• Comprehensive benefits package to meet your financial, health, and work/life balance goals.
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
• Optional identity theft protection, home and auto insurance, pet insurance
• Traditional and Roth retirement options with service contribution and match savings
• Eligibility for benefits is determined by employment type and status

What This Job Offers

• Job Type: Part-time
• Career Level: Entry Level
• Education Level: High school or GED