Corewell Health hiring for Customer Service Representative Medicare jobs in Comstock Park, MI, US
Job Summary
Must be able to start on 03.25.2024
Must live within the State of Michigan for Virtual work requirements.
On-site work may be requested if employee performance needs attention, internet issues or power outages that may occur.
6 Weeks of training (2-3 days on-site for equipment education and a meet/greet in Grand Rapids, MI)
Training Hours 8 a.m. to 4:30 p.m.
Mandatory attendance during training is required
Post Training Hours can vary between:
8 a.m. and 8 p.m. Call Center hours of operation
Shift lengths can be either 8 or 10 hours.
Must be available for weekend schedules.
Pay $16.50 to $17.50/hr
* based on experience, education and department evaluation.
Inbound call center to assist and educate members, employer groups, providers, colleagues, and/or agents of health plan benefits with accessing services, facilitating and resolving problems, understanding claims, billing and coding, along with other questions. Consistently create an exceptional experience with each contact, via inbound and outbound calls, face-to-face interactions, online chat, email, etc.
Inbound call center to assist and educate members, employer groups, providers, colleagues, and/or agents of health plan benefits with accessing services, facilitating and resolving problems, understanding claims, billing and coding, along with other questions. Consistently create an exceptional experience with each contact, via inbound and outbound calls, face-to-face interactions, online chat, email, etc.
Essential Functions
- Analyzes, evaluates, resolves and responds to service inquires from members, providers, employer groups, colleagues, agents, Elite agents (customers), and others within departmental guidelines. Professional and pleasant interactions are ongoing expectations.
- Partnering with internal and external resources, promptly provides customers with information and education concerning benefit clarification, eligibility requirements, verification, authorization, billing and claim status.
- Promptly identifies and resolves or escalates customer concerns or complaints to achieve positive outcomes. Places outbound welcome calls to members to educate them on their benefits as needed. Assists walk-in members and agents if assigned by leadership.
- Adheres to established procedure and quality guidelines in support of Priority Health service promise, key drivers, performance indicators, as well as Corporate values and codes of excellence. Identifies potential trends or issues that impact health plan members and works with coworkers and leadership resources to suggest process improvements.
- Assists members with administrative issues, such as submitting enrollment record changes, providing letter explaining coverage or benefits, and obtaining and relaying certain member information to other departments as needed.
- Facilitates claims resolution through follow-up on member calls and correspondence received to appropriate departments.
- Effectively tracks and/or documents all service interactions with customers within appropriate systems according to guidelines.
- Develops and maintains behaviors of productivity, availability to customers, and adherence to work schedule.
Qualifications
- Required High School Diploma or equivalent
- 1 year of relevant experience in related field Required
- 1 year call center experience preferred
- Preferred Associate's Degree
#CorewellHealthCareers
Primary Location
SITE - Priority Health - 1239 E Beltline - Grand Rapids
Department Name
PH - Customer Service Medicare
Employment Type
Full time
Shift
Variable (United States of America)
Weekly Scheduled Hours
40
Hours of Work
Variable
Days Worked
Monday to Friday
Weekend Frequency
Variable weekends
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Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.
You may request assistance in completing the application process by calling 616.486.7447.