[Remote] Customer Service Representative

Note: The job is a remote job and is open to candidates in USA. Mass General Brigham Health Plan is a not-for-profit organization focused on advancing patient care, research, teaching, and community service. They are seeking a Customer Service Professional who will act as the primary point of contact for members and providers, ensuring exceptional customer satisfaction and first call resolution by handling inquiries and resolving complaints effectively.ResponsibilitiesServes as the primary liaison for members and providers for all lines of business including MassHealth, and Commercial members regarding general program inquires such as eligibility verifications, authorizations, referrals, claims, material fulfillment, address changes and Primary Care Physician assignments as well as member related policy and proceduresThe CSP must be able to handle and demonstrate skills in handling benefits, claims and eligibility calls for the member and provider populationIdentify customer issues/concerns rapidly and preciselyResearch required information using available resources and triage when necessaryHandles and resolve customer inquiries and complaints, exhausting all efforts within the CSP’s scope before requesting assistanceIdentify and escalate priority issues in order to create efficienciesInitiates follow up customer calls where necessaryComplete call logs to record customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions takenRefer customer grievances and appeals to designated departments for further investigationResponsible for navigating multiple systems in order to resolve customer issuesActs as the primary representative for Mass General Brigham Health Plan for our customers focusing on first call resolution and customer engagementAnticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respectSkillsHigh School Diploma or Equivalent requiredExceptional Customer Service skills, both verbal and written communication must be concise, clear, compliant, personable and professionalAbility to multi task and prioritizeMaintain Customer Service Behavior CompetenciesFlexibility/Adaptability/Willingness/Team Player/ Positive AttitudeRelationship Building/CaringService Excellence/Accountability/Critical ThinkingAssociate's Degree in related field or Healthcare Management preferredCall Center experience a plusBenefitsIn addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth.MGB provided equipmentReasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employmentCompany OverviewMass General Brigham Health Plan is an insurance company that offers health plans and research for employees in an organization. It was founded in 1986, and is headquartered in Somerville, Massachusetts, USA, with a workforce of 501-1000 employees. Its website is https://www.massgeneralbrighamhealthplan.org.