Member and Provider Services Representative

Eauclairechamber; Eau Claire (WI); On-site; USD 20,664 - 27,552; Full time

Benefits offered by this job

Three weeks of vacation in the first/j

Generous retirement plan

Health and dental insurance

Wellness program

Job summary

Group Health Cooperative of Eau Claire is seeking a Member and Provider Services Representative to deliver exceptional customer service to cooperative members and providers. The role involves answering calls, educating on telehealth services, documenting interactions, and resolving inquiries promptly.

Ideal candidates have a high school diploma or equivalent, 1–3 years of customer service experience, strong communication skills, and proficiency with Word and Excel.

Qualifications

• High school graduate or equivalent; technical college degree preferred.
• One to three years of customer service experience; call center background preferred.
• Excellent communication and customer service skills.
• Proficient in Microsoft Word and Excel.

Responsibilities

• Answer telephone calls in a pleasant, professional, and efficient manner.
• Answer member and provider questions accurately, educating on telehealth services.
• Document all calls in Trucare using the Probing Questions format.
• Follow up on issues from calls or reminders efficiently and accurately.
• Research member and provider questions using available resources.
• Conduct outgoing calls for timely resolution of inquiries.
• Assist members in person with questions regarding their policy and benefits.
• Educate members on plan policies and procedures.
• Stay up to date on plan options and benefits.
• Comply with all company policies and procedures.

Skills

Customer service

Communication

Microsoft Word

Excel

Education

High school diploma or equivalent

Technical college degree (preferred)

Tools

Trucare CRM

Job description

Member and Provider Services Representative

Position Purpose

The Member and Provider Service Representative provides exceptional customer service and accurate information to Cooperative members and providers.

Essential Position Functions

• Answer telephone calls in a pleasant, professional, and efficient manner assuring exceptional customer service.
• Answer member and provider questions in an accurate and efficient manner incorporating the “Probing Questions” method. Representatives will also educate our members to the telehealth services the Cooperative has to offer.
• Document all incoming calls and outbound calls in Trucare in a complete and accurate manner utilizing the “Probing Questions” format.
• Follow up on issues resulting from phone calls or reminders as efficiently and accurately as possible.
• Research member and provider questions as needed using all the appropriate resources available.
• Conduct outgoing telephone calls for the timely resolution of member and provider inquiries.
• Assist members who come to the Administrative Office in person with questions or inquiries regarding their policy and benefits.
• Educate members on plan policies and procedures at every opportunity.
• Keep up to date on the various plans and benefit structure under each plan.
• Comply with all company policies and procedures.

Minimum Requirements of the Position

• High school graduate or equivalent. Technical college degree in a related field is preferred.
• One to three years of customer service experience, call center background preferred.
• Excellent communication and customer service skills.
• Proficient in the use of Microsoft Word and Excel.

Group Health Cooperative of Eau Claire complies with applicable Federal civil rights laws and does not discriminate, exclude or treat candidates less favorably on the basis of race, color, national origin (including limited English proficiency and primary language), age, disability, or sex (including sex characteristics, including intersex traits; pregnancy or related conditions; sexual orientation; gender identity; and sex stereotypes).

The Cooperative is committed to fostering a caring and compassionate environment while ensuring that individual differences are valued. The Cooperative is a quality driven cooperative built on collaboration, community involvement, innovation, and belonging. It is essential that all employees and members feel secure and welcome, that the opinions and contributions of all individuals are respected and that all voices are heard.

This full time position offers an outstanding benefit package, including three weeks of vacation the first year, a generous retirement plan, health and dental insurance, a wellness program, and much more! If you are interested in working for an organization focused on a team atmosphere and is dedicated to providing exceptional service submit your resume today! Send resume to: [e-mail]. Group Health Cooperative of Eau Claire is an affirmative action and equal opportunity employer.