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Member Services Representative
SureCompanies
 
Job Location: Santa Ana, CA
Description:

*No outside agencies please*

* Only local candidates will be considered *


SureCo is a PURPOSE driven company that's dedicated to disrupting our broken healthcare system. We're 100% focused on driving down the cost of healthcare and improving the quality of care for all of us. SureCo and its subsidiaries and partners are at the forefront of health care change in the U.S. Serving patients, consumers, and enterprises. We focus on innovative technologies, new care paradigms, all focused on aligning our incentives with our customers. Established in 2016 we've grown from 10 to over 100 (and counting) Sureconians what we call our awesome team members!


If you are looking for a company focused on making real change, high energy, and team driven performance then you've found it here at SureCo. Our people are inspiring and are inspired by what we do, who we get to do it with, and who we do it for.


Summary

Our Member Service Representatives are one of the most important pillars to our success. As you're directly interfacing with our most precious assets, our customers. We're looking for top tier talent that takes ownership in creating a successful journey for our clients. This is a challenging role that requires an emphasis on customer satisfaction, high energy, and work with the highest purpose of customer satisfaction and retention. please submit a resume.


Key Responsibilities

  • Answering phones from members professionally and responding to member inquiries and complaints.
  • Handle escalated calls, resolving more complex member issues in (First Call Resolution - FCR)
  • Demonstrate outstanding service to identify the source of the issue and work to resolve member inquiries and issues in a timely and professional manner, related to benefits, eligibility and claims, financial spending accounts and correspondence
  • Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
  • Responsible for knowing all aspects of health program benefits including medical and pharmacy
  • Required to be at workstation to answer calls in an ACD environment, subject to the monitoring of incoming and outgoing ACD calls for quality assurance during those time periods that the CSA is not scheduled for a break or lunch breaks
  • Identifying, escalating priority issues, and reporting to high-level management. Responsible to take issues on a weekly basis to the dept. manager
  • Obtaining and evaluating all relevant data to handle complaints and inquiries
  • Handling outbound and inbound calls from external and internal customers
  • Completing call reports and logs, and researching billing issues
  • Recognizing, documenting, and informing the supervisor regarding the trends in internal and external customer calls


.Requirements:
  • High School Diploma / GED (or higher)
  • 1+ years of customer service experience analyzing and solving customer problems
  • Must have call center experience, preferred in the healthcare industry
  • Ability to create, modify and send documents, spreadsheets, and emails in Microsoft Excel, Word, and Outlook
  • Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manners, consistently meeting commitments)
  • Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member
  • A proficient problem-solving approach to quickly assess the current state and formulate recommendations
  • Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon
  • Flexibility to customize the approach to meet all types of member communication styles and personalities
  • Proficient conflict management skills to include the ability to resolve issues in a stressful situation and demonstrating personal resilience
  • Ability to work regularly scheduled shifts within our hours of operation including the training period where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed
  • All new hires will be required to successfully complete the Customer Service training classes and demonstrate proficiency of the material
  • Ability to work within a team and collaborative environment.
  • Ability to multi-task including the ability to understand multiple products and multiple levels of benefits within each product
  • Demonstrated ability in customer service problem resolution and relationship building
  • Being able to address high-level concerns and satisfy them using scripting
  • Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
  • 1+ years of experience in the Healthcare industry.

Why us?

This is an amazing opportunity to join a growing team at a fast-paced, mission-driven startup. You will be an integral part of the team with a high level of responsibility and room for growth.


Our business is fast-paced and will continue to evolve. As such, the duties and responsibilities of this role may be changed as directed by the Company at any time to promote and support our business needs.


SureCo is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, protected veteran status, or any other basis protected by applicable law and will not be discriminated against on the basis of disability.

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