Current Job Openings

 
 

MEMBER EXPERIENCE TEAM REPRESENTATIVE

The Member Experience Team Representative is responsible for providing accurate and thorough interpretation of Teachers Health Trust Plan benefits, claims processes, eligibility, and enrollment policies to members, employers, and internal customers. In addition, the Member Experience Team Representative is responsible for resolution of complex customer inquiries, the facilitation of problem resolution, and meeting or exceeding customers' expectations.

The Member Experience Team Representative presents a consistent and professional demeanor to all callers and internal customers and is expected to identify opportunities to improve customer service and efficiency. The Member Experience Team Representative is expected to take responsibility for every interaction with a customer by providing outstanding service as a means to build customer loyalty, improve customer retention, and satisfy customer service goals and objectives.
 

Performed Duties may include, but are not limited to:

  • Receives and responds to a high volume of incoming telephone calls from members, prospective members, employers, and internal staff.

  • Efficiently and effectively processes member calls. This includes:

    • Accesses the most appropriate source of information and proficiently resolving the members’ concern.

    • Accurately documents the complete encounter and maintains a professional and supportive attitude throughout the call.

    • Asks probing questions and takes the opportunity to educate members to avoid unnecessary repeat calls.

    • Investigates member complaints and performs front-line analysis and intervention when appropriate.

    • Makes necessary outgoing phone calls to resolve member related inquiries.

  • Meet or exceed department established key performance indicators.

  • Adheres to assigned schedules to ensure appropriate phone queue coverage.

  • Demonstrates strong written (e.g., documents all member interactions accurately and comprehensively) and verbal skills.

  • Employs active listening skills, demonstrates patience and empathy, and is able to handle difficult customers tactfully, courteously and professionally.

  • Strives for improved efficiency for processing member issues.

  • Interacts and forms contacts with other departments in order to resolve issues.

  • Participates in initiatives and/or responds to requests for help to contribute to team and department success.

  • Assists in mentoring new staff as directed.

  • Assist with department projects as needed

  • Ability to toggle multiple systems while working on a PC, including and not limited to a CRM.

  • Ability communicate clearly and concisely with members as well as internal staff.

  • Be a Champion for Member Experience, and carry the torch for Members through to logical conclusion.

  • Ability to roll with change would be a definite plus.

  • Ability to work with diverse teams including the TPA side.

  • Ability to escalate quickly to resolve member concerns, including following up as required.

  • Ability to educate the members on the best possible outcome for their concerns including self-managing health plan services for themselves and their dependents.

  • Prior healthcare experience is a plus, though not a requirement

  • Using discretion and maintaining confidentiality in carrying out job duties involving sensitive personal, health or other business information;

  • Taking initiative and being concise, accurate and detail-oriented in carrying out your job responsibilities;

  • Working collaboratively with other Trust employees and members of the Trust’s executive team to deliver THT’s unique value proposition and aspirational approach to customer service;

  • Being punctual and maintaining regular and reliable attendance;

  • Supporting a culture of collaboration, leading by example, and maintaining a positive and productive work environment