Essential Job Functions and Responsibilities:(This list is neither all-inclusive, nor restrictive; management reserves the right to further define duties based on operational needs.)
Provide a positive customer experience by performing the following:
Receiving calls through the Member Services phone line. Assisting members with inquires and questions, explaining plan and benefit information, eligibility and enrollment guidelines and processes, updating demographic and communication preference changes and responding to various other questions.
Liaison between the member and plan administrators.
Assisting walk-in members with inquires and questions, explaining plan and benefit information, eligibility and enrollment guidelines, assisting with premium payments, and various other questions.
Responds to all questions accurately and promptly, both verbally and in writing, in a respectful, courteous and professional manner.
Establishes and maintains a good rapport with members.
Transfers callers to appropriate MCHCP department as necessary.
Works in conjunction with other MCHCP departments to resolve members’ issues.
Maintains accurate and detailed telephone logs.
Assists with returned mail items as needed and/or reports information to the receptionist for timely mailing of returned mail items (e.g. address updates).
Required Knowledge, Skills and Abilities:
Above average knowledge of employee benefit terminology.
Ability to quickly learn and retain plan provisions, guidelines, rules, regulations and benefits.
Ability to operate a computer keyboard and have good manual dexterity in order to log contents of telephone conversations into computer.
Proficient problem solving skills, using independent judgement as necessary or when directed to do so by supervisor/manager.
Maintain a courteous, pleasant, professional and positive tone of voice while assisting members.
Excellent verbal and written communication skills with the ability to remain consistent and accurate.
Ability to take verbal and written directions and then use independent judgment in accomplishing the required task.
Above average understanding of Microsoft Office including Word, Excel and Outlook.
Ability to establish and maintain professional working relationships with the Member Services team and other MCHCP staff.
Ability to establishing and maintaining professional working relationships with MCHCP members, plan account managers and the general public.
Ability to maintain confidentiality of all MCHCP information and records in accordance with Health Insurance Portability and Accountability Act (HIPAA) and other applicable laws and regulations.
Ability to make independent decisions in accordance with established policies and procedures; and the ability to prioritize, organize and perform work independently, using professional judgement, under the high-pressure demands of the positon.