Company Overview:

Clear Spring Health is part of Group One Thousand One (“Group1001”), a customer-centric insurance group whose mission is to make insurance more useful, intuitive and accessible so that everyone feels empowered to achieve financial security. Clear Spring Health is dedicated to helping seniors protect their health and well-being by providing Medicare Advantage plans in select counties of Colorado, Illinois, North Carolina, and Virginia, plus Georgia and South Carolina and offers Medicare Prescription Drug Plans in 42 states plus DC.

Group 1001, and its affiliated companies, is strongly committed to providing a supportive work environment where employee differences are valued. Diversity is an essential ingredient in making Group 1001 a welcoming place to work and is fundamental in building a high-performance team. Diversity embodies all the differences that make us unique individuals. All employees share the responsibility for maintaining a workplace culture of dignity, respect, understanding and appreciation of individual and group differences.

Job Summary:

The Member Services Representative is the primary point of contact for all Eon Health members and provides all aspects of excellent customer service delivery. This position handles issues related to either member or provider inquiries.

Main Accountabilities:

• Daily tasks include: ongoing incoming and outgoing phone calls; ongoing incoming and outgoing email; ongoing use of member database and members’ electronic medical records; processing paper mail; and processing faxes.
• Respond to and answer all member and provider inquiries in a courteous, responsive, and timely manner following all departmental and organizational policies and procedures.
• Use call tracking systems to document communication with members and providers.
• Work collaboratively with providers and members to ensure effective customer service and issue resolution.
• Arrange interpretation services for members as needed.
• Respond and assist members with Primary Care Provider (PCP) assignments.
• Outreach to members regarding benefits and eligibility requirements.
• Coordinate mailing of member materials as needed.

Qualifications:

• 1+ years prior customer service experience is preferred or related experience.
• High School/GED required, Bachelor’s degree preferred.
• An understanding of the health insurance industry is preferred.
• Must possess exceptional oral and written communication skills, including the ability to manage difficult callers and conflict.
• Ability to multi-task, good organizational and time management skills.
• Analytical skills in research and problem resolution.
• Strong computer skills (keyboard proficient, quick data entry with a high level of accuracy).
• Able to work cooperatively with other departments.
• Strong communication skills, basis computer skills (verbal and written).
• Analytical ability with an affinity to detail, as well as the capability to handle heavy workloads and meet deadlines.
• Must be able to work and act independently and be self-directed.