Member Service Representative

Work At Home
Immediate

Job Description

Grow with a company that is passionate about helping you maximize your full potential! Become a part of transforming customer and client experience through the utilization of our innovative work from home technology. At BroadPath we believe in assuming the highest intention of others, our employees are empowered through their voices! BroadPath is currently hiring Member Service Representatives to work from home! Member Service Representatives will provide excellent customer service primarily by telephone to Medicaid Plan Members and Providers by analyzing needs and providing accurate and timely responses. Come join our Work from Home Team!

Responsibilities

  • Work from home efficiently in a high-volume Call Center setting, repeatedly analyzing situations, utilizing/navigating multiple computer systems simultaneously, while using strong customer service and conflict resolutions skills in a fast-paced environment
  • Answer Plan Benefit questions from Members on Medicaid Medical and Pharmacy Products. Provide solutions to problems and determine an individualized path to resolution by keeping resources up to date and organized and providing information on community resources when appropriate
  • Maintain confidentiality of information for all members by adhering to privacy policies and HIPAA laws and guidelines.  Exercise judgment, initiative, and discretion in confidential and sensitive matters.
  • Provide accurate information in a professional manner using current technology and software to document calls from members, providers, and other customers in a clear and concise manner
  • Work collaboratively and relay information to appropriate internal and external departments and partners using approved company channels and procedures.  Perform outreach to physicians, hospitals, pharmacies, and other providers when necessary to answer questions and obtain or provide information
  • Review, update and become familiar with new and revised benefits, policy information, and/or claim processing procedures
  • Meet department standards and expectations including but not limited to quality, production, and attendance
  • Ability to articulate complex information in an easy-to-understand manner
  • Strong active listening skills and the ability to ask probing questions and understand concerns
  • Perform other related duties as assigned

Basic Qualifications

  • High School diploma or equivalent 
  • Proficient computer skills 
  • Understand insurance and medical terminology

Preferred Qualifications

  • Minimum 1- 2 years’ Customer Service Experience 
  • Minimum 1- 2 years’ Experience in a Healthcare Environment   
  • Claim Processing Experience or prior Customer Service Experience or other related experience such as medical/dental office or pharmacy experience