Member and Provider Services Representative

Group Health Cooperative•Altoona, WI

About The Position

The Member and Provider Service Representative provides exceptional customer service and accurate information to Cooperative members and providers. Essential Position Functions Answer telephone calls in a pleasant, professional, and efficient manner assuring exceptional customer service. Answer member and provider questions in an accurate and efficient manner incorporating the “Probing Questions” method. Representatives will also educate our members to the telehealth services the Cooperative has to offer. Document all incoming calls and outbound calls in Trucare in a complete and accurate manner utilizing the “Probing Questions” format. Follow up on issues resulting from phone calls or reminders as efficiently and accurately as possible. Research member and provider questions as needed using all the appropriate resources available. Conduct outgoing telephone calls for the timely resolution of member and provider inquiries. Assist members who come to the Administrative Office in person with questions or inquiries regarding their policy and benefits. Educate members on plan policies and procedures at every opportunity. Keep up to date on the various plans and benefit structure under each plan. Comply with all company policies and procedures.

Requirements

High school graduate or equivalent.
One to three years of customer service experience, call center background preferred.
Excellent communication and customer service skills.
Proficient in the use of Microsoft Word and Excel.

Nice To Haves

Technical college degree in a related field is preferred.

Responsibilities

Answer telephone calls in a pleasant, professional, and efficient manner assuring exceptional customer service.
Answer member and provider questions in an accurate and efficient manner incorporating the “Probing Questions” method.
Educate our members to the telehealth services the Cooperative has to offer.
Document all incoming calls and outbound calls in Trucare in a complete and accurate manner utilizing the “Probing Questions” format.
Follow up on issues resulting from phone calls or reminders as efficiently and accurately as possible.
Research member and provider questions as needed using all the appropriate resources available.
Conduct outgoing telephone calls for the timely resolution of member and provider inquiries.
Assist members who come to the Administrative Office in person with questions or inquiries regarding their policy and benefits.
Educate members on plan policies and procedures at every opportunity.
Keep up to date on the various plans and benefit structure under each plan.
Comply with all company policies and procedures.