Customer Service/Call Center Representative
Neighborhood Health Plan (NHP) - Boston, MA

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Summary:

Neighborhood Health Plan (NHP), located in Boston, is currently seeking an experienced, highly skilled Customer Service/Call Center Representative , responsible for interacting with members to provide information in response to inquiries about coverage, benefits, and services and to handle and resolve complaints.

The person in this role must be committed to building customer confidence, increasing customer satisfaction by delivering to callers an exceptional experience focused on quality and accuracy.

Primary Responsibilities:
  • Serve as the primary liaison for MassHealth and Commonwealth Care members regarding general program inquiries such as eligibility verifications, authorizations, referrals, material fulfillment, address changes, and Primary Care Physician assignments and member related policies and procedures
  • Identify customer issues/concerns rapidly and precisely
  • Assist members with redetermination inquiries
  • Research required information using available resources
  • Handle and resolve customer complaints
  • Identify and escalate priority issues
  • Route calls to appropriate departments
  • Initiate follow up customer calls where necessary
  • Complete call logs to record customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken
  • Refer customer grievances and appeals to designated departments for further investigation
  • Responsible for navigating multiple systems in order to resolve member issues
  • Perform outreach calls or surveys as required for new members
  • Generate customer correspondence

Preferred Qualifications:
  • High School diploma required; Associates Degree or Bachelors Degree preferred
  • High school and college level courses in computers, English, or business helpful
  • 3+ years in an HMO/Health Insurance setting preferred
  • 3+ years in customer service/call center environment preferred
  • Knowledge of call center telephony and technology
  • Knowledge of customer service principles and practices
  • Hospitality and retail experience helpful
  • Ability to resolve customers' problems and to demonstrate patience and remain courteous when faced with difficult or angry callers
  • Ability to work well under pressure
  • Understanding of Protected Health Information (PHI) and the necessity to maintain confidentiality of this information
  • Use questioning and listening skills that support effective telephone communication
  • Apply the proper telephone etiquette and voice skills to satisfy various customer situations
  • Meets commitments to customers
  • Excellent listening , verbal and written communication and problem-solving skills
  • Energetic, friendly, approachable, and professional demeanor
  • Able to interact well within a multicultural, team environment
  • Attention to detail
  • Demonstrate initiative, judgment, adaptability, and resilience
  • Set realistic and achievable customer expectations
  • Proficiency in Spanish or other language skills desirable
  • Understanding of or training in Medical terminology
  • Proficiency with MS Office suite

NHP offers competitive salaries and an excellent flexible benefits package that includes medical, dental and vision insurance, generous earned time, commuter benefit, and a 401(k) employer contributed retirement program.

NHP’s mission targets a diverse population and our employees are just as diverse. As an equal opportunity employer, NHP recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives, and backgrounds.

Neighborhood Health Plan (NHP) - 12 months ago - save job - block
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About this company
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Working Together for the Health of Our Members Our Members, Our Promise Neighborhood Health Plan is unique among Massachusetts health...