Member Service Representative

🔥 17 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 11%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Open for 1 day.
• Jobs at this company usually fill in 21 days.
• No salary listed.

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Peak Health

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Peak Health is a health insurer and health insurance services company headquartered in Morgantown, West Virginia. It is owned by three not-for-profit health care providers: WVU Health System, Marshall Health Network, and Valley Health. Peak Health aims to improve community health outcomes by offering an inclusive, provider-led health plan for residents of West Virginia and surrounding areas. The company is committed to making health care more accessible, understandable, and collaborative, with a focus on reducing costs and administrative fees for patients and employers. Peak Health also offers Medicare Advantage coverage tailored for West Virginia seniors through partnerships with leading health systems.

📋 Description

• Report to the Manager of Member and Provider Services • Take inbound calls from Peak Health members and answer questions ranging from general information to complex issues • Research and resolve member issues and questions with management and peers • Make outbound calls to members for issue resolution or to gather further information • Verify member information while addressing general questions • Respond to and resolve issues and inquiries to provide an efficient member experience • Maintain open channels of member communication and conduct outreach as required • Meet production and quality standards and maintain work queues according to department standards • Communicate effectively with internal and external staff • Escalate issues to the appropriate level of supervision • Ensure accuracy of information gathered and shared on behalf of members • Attend required training and demonstrate proficiency • Maintain accurate documents, including timekeeping records

🎯 Requirements

• High School diploma/GED • Two (2) years of customer service experience in a call center environment • Associate Degree, or greater, in related healthcare field (preferred) • Two plus years’ experience in a fast-paced call environment with processing and/or customer service experience (preferred) • Working knowledge of administrative and clerical procedures and systems, including word processing and managing files and records • Ability to take direction and navigate through multiple systems simultaneously • Excellent written and oral communication, customer service, interpersonal skills, and telephone etiquette • Ability to solve problems with predefined methods and guidelines • Familiarity with medical insurance services process • Exceptional attention to detail, organization, and ability to perform multiple tasks simultaneously • Ability to work remotely, including reliability, self-motivation, focus, and time management • Ability to communicate clearly, concisely, and articulately while being an astute listener • Ability to sit for extended periods and answer phone calls for extended periods • Ability to lift 10–25 lbs. • Travel requirement: 0%–25% • Proficiency with Microsoft Office Professional Suite, Internet Explorer, and EPIC

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