Member Service Representative

This role reports to the Manager of Member and Provider Services and plays an integral part in improving healthcare. The Membership Services Representative takes inbound calls from Peak Health members to provide general information and resolve complex inquiries. The role also involves outbound calls to members for issue resolution or to gather additional information. Minimum Qualifications High School diploma or GED Two years of customer service experience in a call center environment Preferred Qualifications Associate Degree or higher in a related healthcare field Two or more years of experience in a fast‑paced call environment with processing and/or customer service experience Core Duties and Responsibilities Verify member information while addressing general questions. Respond to and resolve all issues/inquiries to assure an efficient and seamless member experience. Maintain open channels of member communications and conduct outreach as required. Meet all production and quality standards, maintaining work queues according to department standards. Effectively communicate with internal and external staff. Elevate issues to the next level of supervision, as appropriate. Ensure accuracy of information gathered and shared on a member’s behalf. Attend all required training classes, demonstrating proficiency and the ability to learn. Other duties as deemed appropriate by the Management Team. Maintain accurate documents, including timekeeping records. Physical Requirements Ability to sit for extended periods of time. Ability to answer phone calls for extended periods of time. Lifting 10-25 lbs. Travel requirement: 0-25% Working Environment Standard office environment with electrical equipment (telephone, personal computer, copier, fax machines, etc.) Computer software/systems include but are not limited to Microsoft Office Professional Suite (Outlook, Word, Excel, Access), Internet Explorer, and EPIC. Skills and Abilities Working knowledge of administrative and clerical procedures and systems such as 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 to drive improved efficiencies and customer satisfaction. Familiarity with medical insurance services process. Requires exceptional attention to detail, the ability to be organized, and to perform multiple tasks simultaneously. Ability to work remotely – including reliability, self‑motivation, focus, and time‑management skills. Ability to communicate clearly, concisely, and articulately while being an astute listener. Additional Job Details Scheduled weekly hours: 40 Exempt/Non‑Exempt: Non‑Exempt Shift: United States of America Company: PHH Peak Health Holdings Cost Center: 2911 PHH Member Services #J-18808-Ljbffr