Call Center Member Service Representative

Job Description

Job Description

Sr. Call Center Member Service Representative 

Healthcare is increasingly unaffordable for many Americans. Most people believe they have two choices: increasingly expensive, restrictive employer insurance, or an ACA plan that keeps getting pricier. Many don't know there's a third, smarter option.

WeShare  Health is that option. 

WeShare Health’s mission is to make healthcare simpler, more affordable, and more human. We're a nonprofit, faith-inspired healthcare sharing organization where members contribute monthly to share one another's eligible medical expenses. We're proudly not insurance, and that's the point. 

Members access a national network of 1 million physicians at 30 to 60 percent less than comparable traditional insurance. Since 2018, WeShare Health has served more than 100,000 members and shared more than $50 million in medical expenses. Our purpose is clear: people before profit.

WeShare Health is led by senior executives with deep experience across for-profit and nonprofit enterprises. We’re rated 4.6 out of 5 on Google Reviews, rated 4.7 on Trustpilot by members and certified as a Great Place To Work® by our employees. If you have a bias for action, enjoy challenges, and want to challenge the status quo to make an impact in a massive industry, WeShare Health might be the place for you!

About this role

Our Sr. Customer / Member Services Representatives are one of the most important pillars to our success. As you’re directly interfacing with our valuable members. We’re looking for top-tier talent who takes ownership in creating a successful journey for our clients. This is a challenging role that requires an emphasis on customer centricity, high energy, and work with the highest purpose of customer satisfaction and retention.

Key Responsibilities

• Answering phones from members professionally and responding to member inquiries and complaints
• Handle escalated calls, resolving more complex member issues in (First Call Resolution - FCR)
• Demonstrate outstanding service to identify the source of the issue and work to resolve member inquiries and issues in a timely and professional manner, related to benefits, eligibility and claims, financial spending accounts and correspondence
• Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
• Responsible for knowing all aspects of health program benefits including medical and pharmacy
• Required to be at workstation to answer calls in an ACD environment, subject to the monitoring of incoming and outgoing ACD calls for quality assurance during those time periods that the CSA is not scheduled for a break or lunch breaks
• Identifying, escalating priority issues, and reporting to high-level management
• Responsible for taking issues on a weekly basis to the dept. manager
• Obtaining and evaluating all relevant data to handle complaints and inquiries
• Handling outbound and inbound calls from external and internal customers
• Completing call reports, logs, and researching billing issues
• Recognizing, documenting, and informing the supervisor regarding the trends in internal and external customer calls

Required Qualifications

• High School Diploma/GED (or higher)
• 6+ months of Call/Contact Center experience
• 6+ months of Customer Service experience analyzing and solving customer problems

Preferred Qualifications

• Healthcare or Insurance Call/Contact Center experience
• Ability to create, modify and send documents, spreadsheets, and emails in Microsoft Excel, Word, and Outlook
• Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manners, consistently meeting commitments)
• Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the member
• A proficient problem-solving approach to quickly assess the current state and formulate recommendations
• Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon
• Flexibility to customize the approach to meet all types of member communication styles and personalities
• Proficient conflict management skills include the ability to resolve issues in a stressful situation and demonstrating personal resilience
• Ability to work regularly scheduled shifts within our hours of operation including the training period where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and workover-time and/or weekends, as needed
• All new hires will be required to successfully complete the Customer Service training classes and demonstrate proficiency of the material
• Ability to work within a team and collaborative environment
• Ability to multi-task including the ability to understand multiple products and multiple levels of benefits within each product
• Demonstrated ability in customer service problem resolution and relationship building
• Being able to address high-level concerns and satisfy them using scripting
• Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
• Able to work overtime evenings, weekends and holidays as needed based on the needs of the business

What we offer

• Competitive Hourly+ PTO
• Health, Dental, Vision, and 403(b) with company match
• Ability to make important enhancements to the Healthcare industry
• Great culture where you work with the founders and key stakeholders in a relaxed, but innovative atmosphere

WeShare Health is an Equal Opportunity Employer. Our business is fast-paced and will continue to evolve. As such, the duties and responsibilities of this role may be changed as directed by the Company at any time to promote and support our business needs. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, protected veteran status, or any other basis protected by applicable law and will not be discriminated against on the basis of disability.