Member Service Representative I

Martin's Point Health Care Inc.; New York (NY); On-site; USD 28,000 - 34,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Retirement plan

Paid time off

Pie day

Other benefits

Job summary

Martin's Point Health Care is seeking a Member Service Representative I to support Health Plan members by delivering accurate information and ensuring high-quality service. The role emphasizes compliance, timely responses, and building loyalty across member, broker, and internal teams.

The position requires a High School diploma (or equivalent) with 2+ years in customer service. Strong MS Office skills and excellent telephone/interpersonal abilities are essential for success in a fast-paced

Qualifications

• High School diploma or equivalent required.
• ,

Responsibilities

• Services all current member needs for their designated line of business via telephone, in writing, and in person in accordance with departmental service standards and all regulatory requirements.
• Works with the Member Service Representative II for support when needed, coordinates resolution of inquiries with other departments.
• Provides benefit, claims, and coverage information to members per policies and compliance.
• Performs administrative activities in relation to Member Services.
• Maintains accurate information and documentation in all systems and databases.
• Participates in Member Service process improvement events and other projects as assigned.

Skills

Customer service

Telephone skills

Interpersonal skills

Microsoft Office

Call systems

Detail oriented

Multitasking

Education

High School diploma or equivalent

Tools

Microsoft Office

Job description

About Martin's Point Health Care

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.

Position Summary

The Member Service Representative I will interact and support our Health Plan members to ensure customer satisfaction, member loyalty, and retention while maintaining high quality, delivering accurate and timely information, and meeting compliance requirements.

Key Outcomes

Delivers world-class customer service by upholding the Martin’s Point Culture Statement of People Caring for People, modeling the Martin’s Point Values, and building key relationships with members, contracted brokers, other teams, and departments to help promote the success of Martin’s Point.

Responsibilities

• Services all current member needs for their designated line of business via telephone, in writing, and in-person in accordance with departmental service standards and all regulatory requirements.
• Works with the Member Service Representative II for support when needed, as well as coordinates the resolution of inquiries with other departments at Martin’s Point.
• Provides benefit, claims, and coverage information to members in accordance with department policies and procedures and compliance requirements.
• Performs administrative activities in relation to Member Services.
• Maintains accurate information and documentation in all systems and databases.
• Participates in Member Service process improvement events and other projects as assigned.

Education & Experience

• High School diploma or equivalent.
• Post-secondary education preferred.
• 2+ years’ experience in customer service.

Required Licenses / Certifications

Required License(s) and/or Certification(s):

Skills / Knowledge / Competencies (Behaviors)

• Demonstrates an understanding of and alignment with Martin’s Point Values.
• Customer Service - Ability to relate to internal and external customers in a positive and professional manner while proactively meeting the customers’ needs and exceeding Martin’s Point quality standards.
• Computer skills - Expert knowledge in Microsoft Office Suite, ability to learn and adapt quickly to new applications, and an understanding of telephonic systems, call recording, and tracking systems.
• Outstanding telephone and interpersonal skills.
• Ability to work in a fast paced, high stress environment.
• Ability to prioritize and multi-task while maintaining focus on department objectives.
• Ability to function independent and within a team.
• Takes appropriate initiative while soliciting input/advice appropriately.
• Prioritizes time and tasks efficiently and effectively.
• Detail and deadline-oriented.
• Ability to work collaboratively with other members of the Member Services team as well as others throughout the organization.

There are additional competencies linked to individual contributor, provider, and leadership roles. Please consult with your leader to discuss additional competencies that are relevant to your position.

Pay Range

Pay Range: $20.20 - $24.95 The pay range above reflects the anticipated base pay range based on a full-time position. Actual compensation will be determined based on factors such as experience, skills, qualifications, and other job-related considerations. Employees may also be eligible for additional compensation, including incentive or commission-based programs, where applicable and subject to the terms of the relevant plan.

Benefits

• medical
• dental
• vision
• retirement savings with employer contributions
• paid time off (including volunteer time off!)
• pie day
• other employee benefits

Other Employment Information

This position is not eligible for immigration sponsorship.

We are an equal opportunity/affirmative action employer.

Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact [e-mail].

Contact

Do you have a question about careers at Martin’s Point Health Care? Contact us at: [e-mail]

Martin’s Point Health Care is a progressive, not-for-profit organization providing care and coverage to the people of Maine and beyond. The organization operates six primary care health care centers in Maine and New Hampshire, accepting most major insurance plans. Martin’s Point also administers two health plans: Generations Advantage (Medicare Advantage plans available throughout Maine), and the US Family Health Plan (TRICARE Prime® plan for active-duty and retired military families in Maine, New Hampshire, Vermont, upstate New York, northern and western Pennsylvania, and northeastern and central Ohio).

For more information, visit https://careers.martinspoint.org.