Member & Provider Service Representatives - Work from Home

Job Summary

In this role, you will serve as the first line of support for our stakeholders by providing accurate and thorough information to current and prospective members, providers and internal customers about our various health plans. In this role, you’ll make a difference for others every day. This role has also proven to be an excellent starting point for long-term growth and advancement in our company.

Our Investment In You

• High-performing representatives may be eligible for promotion and pay increases within their first year through our Career Progression program
• Annual Commitment to Service bonus for Customer Care representatives, program requirements apply
• WellSense is committed to offering team members the opportunity to grow their career within the company. We encourage team members to pursue new roles within the company and qualified internal candidates are given preference when possible.
• We believe in recognizing and rewarding outstanding performance and dedication to our members. Various department specific and company-wide reward and recognition programs are in place to support this commitment.
• Bring your enthusiasm and people skills, and we will train you on the health insurance business and how to confidently resolve inquiries.
• Paid 12-week training period
• New hire buddy program
• Dedicated Team Assist Line to support complex/challenging calls in real time
• Robust training and skills development opportunity through Ulysses Learning, a leader in customer service and call center learning programs
• One-on-one coaching and mentoring from dedicated training and quality professionals
• We are proud of our comprehensive employee benefits and generous paid time off program.
• Team members are encouraged to participate in a variety of engagement activities including our Business Resource Groups (BRGs), where you can connect with colleagues, grow professionally and share your experiences.

Key Functions Of The Job

• Customer Interaction & Problem Resolution: Own each customer interaction by utilizing the appropriate resources to accurately interpret and respond to inquiries. Deliver outstanding, empathetic service that fosters trust, builds loyalty, and contributes to member retention.
• Call Management: Respond to a high volume of inbound calls from members and providers, addressing a wide range of topics. Calls may vary significantly in length and complexity, requiring adaptability and attention to detail.
• Communication & Conflict Resolution: Apply strong interpersonal and conflict-resolution skills to manage challenging calls with professionalism, courtesy, and empathy.
• Accurate Documentation: Record call details and customer interactions accurately in accordance with departmental standards and compliance requirements.
• Collaboration & Teamwork: Work collaboratively with peers and cross-functional teams to resolve issues, contribute to shared goals, and foster a positive team environment.
• Performance Goals: Consistently meet or exceed departmental goals related to quality, productivity, customer satisfaction, and compliance.
• Flexibility: Support the department by performing additional duties as needed, demonstrating reliability and adaptability.