Member Services Representative I

Looking for a way to influence the health and healthcare of many?

If so, we'd love to hear from you! Our mission-driven organization is focused on the "Triple Aim" - Better Health, Better Healthcare and Lower Costs to individuals and their families who participate in our health plans.

UNITE HERE HEALTH serves 190,000+ workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!

Key Attributes:

• Integrity - Must be trustworthy and principled when faced with complex situations.
• Ability to build positive work relationships - Mutual trust and respect will be essential to the collaborative relationships required.
• Communication - Ability to generate concise, compelling, objective and data-driven reports.
• Teamwork - Working well with others is required in the Fund's collaborative environment.
• Diversity - Must be capable of working in a culturally diverse environment.
• Continuous Learning - Must be open to learning and skill development. As the Fund's needs evolve, must be proactive about developing new areas of expertise.
• Lives our values - Must be a role model for the Fund's BETTER Culture and Mission (Better, Engage, Teamwork, Trust, Empower, Respect)

UNITE HERE HEALTH is seeking a Member Services Representative I to be the face of the fund, especially to members and to provide benefit, eligibility, claim and health care education, information and issue resolution to a multi-cultural community. The Member Services Representative shares the UNITE HERE HEALTH message by encouraging the utilization of benefits according to plan benefits and best healthcare value, while optimizing the member's service experience.

ESSENTIAL JOB FUNCTIONS AND DUTIES

• Serves as the main point of contact for the Fund's members, unions, employers, providers, and vendors on benefit, claims and eligibility issues, education and questions
• Receives and records telephone and walk-in inquiries regarding plan benefits, claims and eligibility
• Performs enrollment functions, including telephonic and in-person outreach
• Encourages members to take steps to get involved in programs to improve their health Recognizes and communicates issues to management including trends and anomalies
• Researches benefit, eligibility and claim issues and initiates corrective action with relevant departments
• Maintains up-to-date knowledge of all systems and sources relating to plan benefits, processes, policies, etc. that will affect performance of daily tasks
• Assists in member outreach, including telephonic and face to face in the Fund office, union office and worksites
• Seeks management assistance on issues unable to resolve in a timely manner
• Participates in benefit presentations
• Assists in daily office operations
• Sets goals and achieve measurable results
• Contributes ideas to plans and achieving department goals
• Demonstrates the Fund's Diversity and Inclusion (D&I) principles in their conduct at work and contributes to a safe inclusive culture with equitable opportunities for success and career growth
• Exemplifies the Fund's BETTER Values in contributing to a respectful, trusting, and engaged culture of diversity and inclusion
• Performs other duties as assigned within the scope of responsibilities and requirements of the job
• Performs Essential Job Functions and Duties with or without reasonable accommodation

ESSENTIAL QUALIFICATIONS

Years of Experience and Knowledge

• 0 ~ 2 years of direct experience minimum in healthcare, insurance, Union or community engagement environment
• Experience with multi-cultural communities
• Working knowledge and experience in customer service duties in person and/or over the phone
• Experience in call center preferred

Education, Licenses, and Certifications

• Associate's degree in Healthcare or related field or equivalent work experience required

Skills and Abilities

• Intermediate level Microsoft Office skills (Word, Outlook)
• Beginner level Microsoft Excel skills
• Intermediate level system(s) skills in computer and keyboarding
• Required fluency (speak and write) in Spanish
• Listening and communication skills (written and verbal)
• Customer service and relationship building skills
• Team, research and problem solving skills
• 10% ~ 15% travel
• Ability to connect with others on a personal level

Hourly range for this position: $18.46~$22.61 - Actual hourly rate may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location.

Work Schedule (may vary to meet business needs): Monday ~ Friday, 7.5 hours per day (37.5 hours per week) with potential for hybrid work-from-home arrangement.

We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Pension, Short- & Long-term Disability, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP).