Member Service Representative- Peak Health

WVU Medicine

2d•Remote

About The Position

This position will report to the Manager of Member and Provider Services, playing a unique and important role in our mission to change healthcare for the better. Experience in the healthcare industry, critical thinking, and compassionate communication skills will help the organization build an effective and efficient Membership Services Team. The Membership Services Representative will take inbound calls from Peak Health members, answering questions ranging from general information to complex inquires on a wide range of issues. The Membership Services Representative will work with management and peers on the Peak team to research and resolve member issues and questions. This role, in addition to taking inbound calls, will make outbound calls to members with issue resolution or to gather further information. Ability to think critically and communicate effectively while following organizational policies and procedures is a must.

Requirements

High School diploma/GED
Two (2) years of customer service experience in a call center environment
Ability to think critically and communicate effectively while following organizational policies and procedures is a must.

Nice To Haves

Associate Degree, or greater, in related healthcare field.
Two plus years’ experience in a fast-paced call environment with processing and/or customer service experience.
Familiarity with Medical insurance services process.

Responsibilities

Verify member information while addressing general questions.
Responds to and resolves all issues/inquires to assure an efficient and seamless member experience.
Maintains open channels of member communications doing outreach as required.
Meets all production and quality standards, maintaining work queues according to department standards.
Effectively communicates with internal and external staff.
Elevates issues to next level of supervision, as appropriate.
Ensures accuracy of information gathered and shared on a member’s behalf.
Attends all required training classes, demonstrating proficiency and ability to learn.
Other duties as deemed appropriate by the Management Team.
Maintain accurate documents, including timekeeping records