Customer Service Representative

Site : Mass General Brigham Health Plan Holding Company Inc.

Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and community service striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

The Customer Service Professional (CSP) acts as the primary point of contact for our members providers and other key stakeholders

focusing on exceptional customer satisfaction and first call resolution. The CSPs interact with customers to provide information and

troubleshoot complex issues in response to inquiries about coverage benefits services and to handle and resolve complaints.

The person in this role must be committed to building customer confidence and increasing customer satisfaction by delivering to callers an

exceptional experience focused on quality and accuracy.

The CSPs will be initially trained on member demographic changes and benefit inquires. Additional member claims training will be delivered

60 days after CSP has completed benefits and eligibility training After successfully demonstrating core competencies by meeting or

exceeding key performance measurements the individual will be trained to handle Provider claims inquiries as business needs dictate.

• Serve as the primary liaison for members and providers for all lines of business including MassHealth and Commercial members regarding general program inquires such as eligibility verifications authorizations referrals claims material fulfillment address changes and Primary Care Physician assignments as well as member related policy and procedures.
• The CSP must be able to handle and demonstrate skills in handling benefits claims and eligibility calls for the member and provider population.
• Identify customer issues / concerns rapidly and precisely
• Research required information using available resources and triage when necessary
• Handle and resolve customer inquiries and complaints exhausting all efforts within the CSPs scope before requesting assistance
• Identify and escalate priority issues in order to create efficiencies
• Initiates follow up customer calls where necessary
• Complete call logs to record customer interactions and transactions recording details of inquiries complaints and comments as well as actions taken
• Refer customer grievances and appeals to designated departments for further investigation
• Responsible for navigating multiple systems in order to resolve customer issues
• Act as the primary representative for Mass General Brigham Health Plan for our customers focusing on first call resolution and customer engagement.
• Anticipates and meets or exceeds internal and / or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.
• Maintain Customer Service Behavior Competencies
• Communication
• Flexibility / Adaptability / Willingness / Team Player / Positive Attitude
• Relationship Building / Caring
• Service Excellence / Accountability / Critical Thinking

Qualifications

High School Diploma or Equivalent required or Associates Degree Healthcare Management preferred

Additional Job Details (if applicable)

Monday - Friday EST hours schedule is as follows :

This is a remote position; a quiet secure stable and compliant work station is required.

Remote Type

Remote

Work Location

399 Revolution Drive

Pay Range

$19.42 - $27.74 / Hourly

Grade

At Mass General Brigham we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive and any offer extended will take into account your skills relevant experience if applicable education certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however it does not encompass all elements contributing to your total compensation addition to competitive base pay we offer comprehensive benefits career advancement opportunities differentials premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement :

Mass General Brigham Health Plan Holding Company Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religious creed national origin sex age gender identity disability sexual orientation military service genetic information and / or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process to perform essential job functions and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973 the Vietnam Veterans Readjustment Act of 1974 and Title I of the Americans with Disabilities Act of 1990 applicants who require accommodation in the job application process may contact Human Resources at .

Mass General Brigham Competency Framework

At Mass General Brigham our competency framework defines what effective leadership looks like by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance make hiring decisions identify development needs mobilize employees across our system and establish a strong talent pipeline.

Required Experience :

Unclear Seniority

Key Skills

Typing,Data Entry,Customer Service,Basic Math,Computer Skills,Windows,Banking,Upselling,Pricing,Sanitation,Cash Handling,Stocking

Employment Type : Full Time

Experience : years

Vacancy : 1

Hourly Salary Salary : 19 - 27