Results-driven, detail oriented team player with a strong background in training and customer relations. Seeking a position that offers professional challenges, utilizes problem-solving and interpersonal skills.
-Coach and support Member Services Representatives with content knowledge, workflows, and de-escalation strategies through written and verbal communications.
- Proactively identify gaps in Member Services Representative’s training to target areas requiring improvement for increased efficiency.
-Take over escalated incoming calls and secure messages when needed to ensure member satisfaction.
-Resolve complex member issues; analyzing problems and using documented workflows to communicate with Claims, Provider Outreach, Eligibility, Medical Review and IT teams.
- Make outbound calls to members, healthcare providers and the Health Insurance Marketplace to facilitate resolutions to member's issues.
-Accurately document all member related interactions in Jira system.
- Quickly answer incoming calls, greeting members in a friendly and professional manner.
- Research all available resources to resolve member’s issues and appropriately escalate to other teams.
- Follow approved workflows to provide accurate benefit and provider information.
- Make outbound calls to members, facilities, providers and the Federal Marketplace when needed.
- Accurately document in detail all member interactions.
- Train and support teammates through Slack, shadowing sessions and team meetings.