Member Services Representative
Steward Health Care Network (SHCN) takes pride in its community-based care model, which drives value-added tools and services to our communities, patients, physicians, and hospitals across the continuum of care. In addition, Steward Health Care Network promotes care coordination and collaboration within the network in order to provide high-quality, efficient care to patients. With Steward in the community, all residents can be sure that there is a world-class doctor close to where they live.
The network is also responsible for the implementation and execution of our managed care contracts, medical management services, quality improvement programs, data analysis, and information services.
Position Purpose: The Member Services Representative provides superior customer service to members and providers, including completing all necessary requests, documenting all calls, completing all forms, answering phones, and meeting monthly goals.
- Provide customer service through inbound/outbound contact.
- Responsible for meeting call metrics in association to specific role.
- Respond efficiently and accurately to callers, explaining possible solutions.
- Greets caller accurately and appropriately, according to established protocol. Uses standard closing accurately and appropriately, while following proper documentation guidelines.
- Abides by HIPAA regulations.
- Keep accurate reporting and effectively communicate weekly progress to supervisor.
- Utilize software, databases, scripts, and tools appropriately.
- Attend team and individual meetings as required.
- Maintain team relationships and help foster a positive work environment.
- Meet personal/team qualitative and quantitative goals.
- Learn and perform other duties in other lines of business, as needed.
- Follows all call management requirements; including schedule adherence.
- Complete all necessary trainings and follow company policies.
- Create goals and pursue career development
Education / Experience / Other Requirements
- High School Diploma or GED
- Associates Preferred
Years of Experience:
- Minimum: 2 years’ customer experience (Call Center experience preferred)
- Preferred: 4 years’ customer experience (Call Center experience preferred)
- Microsoft Office programs
- Medicare and Medicaid
- Excellent communication abilities
- Must be flexible, organized, and function well under pressure
- Ability to learn and assist in other job roles
- Bi-lingual English/Spanish preferred
- Knowledge in health care services and medical terminology desired
- Call Center technology and programs
Steward Health Care is an Equal Employment Opportunity (EEO) employer. Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic.
Steward Health Care Network is taking additional, necessary preparations to ensure patients can receive compassionate care in a safe, carefully managed environment – with confidence and without fear.
Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience:
- Any COVID-19 related care takes place in designated areas away from other patients and their families.
- A stringent cleaning policy has been implemented throughout our facilities.
- A strictly controlled visitor and masking policy is required for patient and colleague safety.
You can rest assured that we have made the necessary preparations to provide care in a safe, controlled and professional way.