Member Service Representative I

martin; Portland (ME); On-site; USD 28,000 - 34,000; Full time

Job summary

Martin's Point Health Care is seeking a motivated Member Service Representative I to support our Health Plan members. You will deliver world-class service by answering questions, providing benefit, claims, and coverage information, and ensuring accurate documentation across systems.

This full-time role requires a high school diploma and 2+ years of customer service experience. You will work with a collaborative team, adhere to regulatory requirements, and contribute to process improvements while

Qualifications

• High School diploma or equivalent required; post-secondary education preferred.
• 2+ years' experience in customer service.
• Excellent communication and interpersonal skills.

Responsibilities

• Delivers world-class customer service by upholding the Martin's Point Values and building relationships with members and brokers.
• Assists with benefit, claims, and coverage information in accordance with policies.
• Coordinates inquiries with other departments and supports onboarding of new members.
• Maintains accurate information in all systems and databases.
• Participates in process improvement events and other projects as assigned.

Skills

Customer Service

Telephone skills

Microsoft Office Suite

Multitasking

Teamwork

Attention to detail

Time management

Education

High School diploma or equivalent

Post-secondary education preferred

Tools

Microsoft Office Suite

Job description

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.

Job Description

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.
• 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.

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 independently 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

$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.

In addition to base compensation, we offer a comprehensive benefits package including medical, dental, vision, retirement savings with employer contributions, paid time off (including volunteer time off!), pie day, and other employee benefits.

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

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]

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