MEMBER SERVICE REPRESENTATIVE
: Job Details :

Description

COMPANY OVERVIEW

Zing Health is a tech-enabled insurance company making Medicare Advantage the best it can be for those 65-and-over. Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the healthcare equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs, and a dedicated care team. For more information on Zing Health, visit www.myzinghealth.com.

SUMMARY

The Member Service Representative acts as the primary contact for Zing members. The representative is responsible for managing and resolving inquiries and issues with accuracy. The representative is responsible for documenting in detail caller engagement information which may include member information, description of concern, resolution, and follow-up action.

JOB RESPONSIBILITIES:

* Provide service resolutions within targeted service levels and serve as the first line of contact for escalated service issues.

* Aim to provide resolution during the first call for all inbound inquiries.

* Interact with members, providers, and other caller types via phone, email, web services, etc. while performing data entry functions for all activity.

* Effectively navigate and comprehend all elements of Zing Health systems, and partnering systems, that are applicable to the business.

* Provide timely and accurate information to callers, while proactively partnering with team members and other departments, as necessary, to facilitate effective, compliant, and quality resolutions.

* Understand CMS guidelines for managing business areas including, but not limited to, membership, provider partnerships, marketing, enrollment/disenrollment, and claims.

* Advise callers of their onboarding process, coverage details, benefits, etc.

Requirements

QUALIFICATIONS AND REQUIREMENTS:

* Maintain target performance metrics, that may include, but are not limited to, call handling, caller satisfaction, quality, STAR score initiatives, etc. while maintaining an average audit score of 95% on a rolling basis.

* Provide ongoing, and proactive feedback to leadership team when challenges with business execution arise.

EDUCATION:

REQUIRED:

* High school GED

* 2+ years in customer service, preferably with 1 year within a call center environment

PREFERRED:

* 2+ years in health insurance, specifically Medicare

HC60-10-501