About The Position

Fallon Health is hiring Member Services Representatives to serve as the primary point of contact for members and providers calling its 1-800 numbers. Representatives answer inquiries and explain plan policies, procedures, and benefits, while representing Fallon Health as a brand and membership ambassador. The role involves understanding callers’ needs and taking appropriate action, within company and department policies, to resolve inquiries and concerns. The position includes a skill-based progression training program with blended learning and personalized coaching. Training takes place onsite in Worcester, Massachusetts, for approximately 8–9 weeks; the remote work model can begin afterward. Many day shifts are available, with schedules discussed during the interview process. Strong performance and initiative can provide exposure to other functions and opportunities for career advancement.

Requirements

  • At least 2 years of professional work experience, preferably in a customer-facing inbound call-center setting.
  • Ability to type at least 25 words per minute net.
  • Ability to multitask.
  • Strong typing skills and high proficiency with MS Word, MS Excel, and system data entry.
  • Ability to complete approximately 8–9 weeks of onsite training in Worcester, Massachusetts before moving to the remote work model.

Nice To Haves

  • High school diploma or GED; relevant customer-service call-center experience may be considered in lieu of this.
  • Bachelor’s degree or other advanced education.
  • Experience in a customer-facing inbound call-center setting.

Responsibilities

  • Develop job knowledge and skills using the training program’s materials and framework.
  • Take ownership of customer satisfaction and serve as a primary liaison for members seeking information or support.
  • Understand member and provider needs and take appropriate action, within company and department policies, to address inquiries.
  • Document call details clearly and concisely for tracking member and provider contacts.
  • Identify and communicate trends that may indicate enterprise service issues.
  • Escalate member or provider concerns and servicing issues as appropriate.
  • Follow corporate and department policies and practices.

Benefits

  • Health insurance
  • Paid time off
  • Training and personalized coaching
  • Career development and advancement opportunities
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