Virtual Remote Jobs in Boston, MA (NOW HIRING)

• Inbound Call Management- Handle inbound calls from members with professionalism and attentiveness, addressing inquiries related to health insurance benefits, coverage, claims and eligibility.
• Health Care System Navigation- support and advocate for members to ensure that they receive the care/support needed
• Problem Resolution- Provide education and guidance to members about their Point32Health benefits and take ownership of each call to ensure that issues are resolved promptly and accurately. Follow up with members as needed to ensure complete resolution.
• Member Engagement- Assist members in understanding and accessing theit benefits and educate members on how to use self service tools, deliver proactive/anticpatory service
• Documentation and Reporting- Record call details and member interactions in the system accurately, ensuring that all relevant information is documented for future reference and reporting ensuring HIPPA, State and Federal regulations and confidentiality standards are met.
• Team Collaboration- Work collaboratively with other team members and departments to address complex issues and ensure a seamless member experience.
• Member Experience- As a brand ambassador for Point32Health, go above and beyond to ensure member satisfaction, proactively identifying and addressing needs and concerns.
• Continuous Improvement- Represent the voice of the customer by contributing to continuous improvement initiatives and providing feedback on member interactions and suggesting process enhancements.
• Metrics & Goals- Adhere to assigned schedules to ensure appropriate phone queue coverage & meet or exceed department established key performance indicators
• Member Retention & Outbound Campaigns- Execute outbound calls to improve the member experience and assist in member retention
• Compliance and Policy Adherence-Ensure all interactions are HIPAA compliant and adhere to state and federal regulations
• Other duties as assigned.

Qualifications - what you need to perform the job.

Education, Certification and Licensure

Required: Associate degree or equivalent work experience

Preferred: Bachelor's degree or equivalent work experience preferred.

Experience (minimum years required):

Required

• 0-2 years of relevant experience.

Preferred

• Customer service experience in health care, call center or corporate office.
• Knowledge of medical terminology.
• Prior experience training and working in a virtual/remote setting.

Skill Requirements

• Customer Service Expertise- Demonstrated ability to provide exceptional service, including active listening, empathy, and clear communication with members.

• Empathy- Ability to put yourself in someone else's shoes and demonstrate compassion.

• Product Knowledge- Strong understanding of health insurance products, policies, and industry regulations, or the ability to quickly learn and apply new information.

• Problem-Solving/Critical Thinking Skills- Adept at identifying issues, analyzing information, and providing effective solutions in a timely manner.

• Communication Skills- Excellent verbal and written communication skills, with the ability to convey complex information clearly and professionally.

• Attention to Detail- High level of accuracy in handling member information, processing requests, and documenting interactions.

• Multitasking Ability- Capable of managing multiple tasks simultaneously while maintaining focus and efficiency.

• Technical Proficiency- Comfortable using computer systems, CRM software, and other relevant technology to manage member interactions and data.

• Adaptability- Ability to adjust to changing priorities and new processes in a dynamic work environment.

• Team Collaboration- Strong people skills with the ability to work effectively with team members and contribute to a positive work atmosphere.

• Conflict Resolution- Skilled in managing and resolving conflicts and complaints with professionalism and patience.

Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel):

• Must be able to work under normal office conditions and work from home as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• May be required to work additional hours beyond standard work schedule.

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.