Member Services Representative

Customer Service Miramar, Florida


Description

Position at Clear Spring Health

Group1001 is a consumer-centric, technology-driven family of insurance companies on a mission to deliver outstanding value and operational performance by combining financial strength and stability with deep insurance expertise and a can-do culture. Group1001’s culture emphasizes the importance of collaboration, communication, core business focus, risk management, and striving for outcomes. This goal extends to how we hire and onboard our most valuable assets – our employees.

Clear Spring Health

Member Services Representative

Location:  Miramar, FL 

Company Overview

Clear Spring Health is part of Group One Thousand One (“Group1001”), a customer-centric insurance group whose mission is to make insurance more useful, intuitive and accessible so that everyone feels empowered to achieve financial security.  Clear Spring Health is dedicated to helping seniors protect their health and well-being by providing Medicare Advantage plans in select counties of Colorado, Illinois, North Carolina, and Virginia, plus Georgia and South Carolina.  In addition, Clear Spring Health sponsors Medicare Prescription Drug plans in 42 states.

Job Summary

The Member Services Representative is the primary point of contact for all Eon Health members and provides all aspects of excellent customer service delivery. This position handles issues related to either member or provider inquiries.

Main Accountabilities

  • Daily tasks include: ongoing incoming and outgoing phone calls; ongoing incoming and outgoing email; ongoing use of member database and members’ electronic medical records; processing paper mail; and processing faxes.
  • Respond to and answer all member and provider inquiries in a courteous, responsive, and timely manner following all departmental and organizational policies and procedures.
  • Use call tracking systems to document communication with members and providers.
  • Work collaboratively with providers and members to ensure effective customer service and issue resolution.
  • Arrange interpretation services for members as needed.
  • Respond and assist members with Primary Care Provider (PCP) assignments.
  • Outreach to members regarding benefits and eligibility requirements.
  • Coordinate mailing of member materials as needed.

Qualifications

  • 1-2 years prior customer service experience is preferred or related experience.
  • High School/GED required, Bachelor’s degree preferred.
  • An understanding of the health insurance industry is preferred.
  • Must possess exceptional oral and written communication skills, including the ability to manage difficult callers and conflict.
  • Ability to multi-task, good organizational and time management skills.
  • Analytical skills in research and problem resolution.
  • Strong computer skills (keyboard proficient, quick data entry with a high level of accuracy).
  • Able to work cooperatively with other departments.
  • Strong communication skills, basis computer skills (verbal and written).
  • Analytical ability with an affinity to detail, as well as the capability to handle heavy workloads and meet deadlines.
  • Must be able to work and act independently and be self-directed.