The Member Services Representative is accountable for successfully addressing member and provider inquiries received through Fallon Health's 1-800 numbers, as well as providing direction on Plan policies, procedures, and benefits. Some key responsibilities include:Ownership for development of knowledge and skills, as training program provides material and framework for success. Ownership for customer satisfaction. Member Service Representatives are the primary liaison for our members to obtain the information or support they need As such, our representatives are expected to fully understand member/ provider needs, and within corporate/ department policies, take whatever action is necessary to fully satisfy the inquiry. Clear and concise documentation of call detail for tracking of member/ provider contacts. Identification and communication of trends that are indicative of enterprise service issues. Escalation of member/provider concerns and servicing issues. Appropriate execution of co...Benefits, Training, Call Center, Service, Remote, Member Service, Technology, Healthcare
Fallon Community Health Plan
07/06/2024
Worcester,MA