Member Services Representative, Sr. addresses more complex health plan or HMO member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for receiving, responding to, and directing member phone calls and written requests. Being a Member Services Representative, Sr. provides available information upon request and researches or escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines. Additionally, Member Services Representative, Sr. requires a high school diploma or equivalent. Typically reports to a supervisor or manager. The Member Services Representative, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Member Services Representative, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)
Job Title: Member Service Representative
Department: Member Services
Reports To: Director of Member Services
FLSA Status: Non-exempt
Safety Sensitive: No
Summary
Assist with service and billing inquiries in a manner which provides a positive experience for the membership and general public for electric and fiber services.
Standards of Excellence
The standards of excellence represent the code of conduct required of every employee to ensure a culture of excellence is maintained throughout the cooperative.
Essential Duties and Responsibilities
Competencies
Adaptability – Adapts to changes in the work environment, manages competing demands, accepts criticism and feedback and changes approach or method to best fit the situation. Exhibits ability to learn and apply new skills.
Continuous Learning – Assesses own strengths and weaknesses, seeks feedback to improve performance, pursues training and development opportunities, strives to continuously build knowledge and skills, shares expertise with others.
Cooperation – Exhibits objectivity and openness to others' views, exhibits tact and consideration, displays positive outlook and pleasant manner, offers assistance and support to coworkers, works cooperatively in group situations and works actively to resolve conflicts.
Use of Technology – Demonstrates required skills, adapts to new technologies, troubleshoots technological problems, keeps technical skills up to date, uses technology to increase productivity
Dependability — Responds to requests for service and assistance, follows instructions, responds to management direction, takes responsibility for own actions, commits to doing the best job possible, keeps commitments and meets attendance and punctuality guidelines.
Initiative - Volunteers readily, undertakes self development activities, seeks increased responsibilities, looks for and takes advantage of opportunities and asks for help when needed.
Teamwork – Balances team and individual responsibilities, exhibits objectivity and openness to others' views, gives and welcomes feedback, contributes to building a positive team spirit and puts success of team above own interests.
Customer Service – Displays courtesy and sensitivity, manages difficult or emotional customer situations, meets commitments, responds promptly to customer needs and solicits customer feedback to improve service.
Qualifications/Certifications
Education and Experience—A High School graduate or equivalent required. Some college courses, an Associate Degree or two years of customer service experience is preferred. Call center and sales experience is highly desired.
CPR Certifications is required.
Classification
This position is eligible for remote work if approved by Management. All essential duties can be performed remotely.
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