Customer Service Representative. Member Services Call Center
Location: Fulton
Posted on: June 23, 2025
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Job Description:
Date Posted: 06/13/2025 Hiring Organization: Rose International
Position Number: 484174 Industry: Healthcare Job Title: Customer
Service Representative. Member Services Call Center Job Location:
Fulton, MD, USA, 20759 Work Model: Hybrid Work Model Details:
Remote (Local to Fulton, MD) Shift: Weekend work is required, with
shifts ending as late as 9:30 PM EST Employment Type: Temporary
FT/PT: Full-Time Estimated Duration (In months): 7 Min Hourly Rate
($): 20.57 Max Hourly Rate ($): 20.57 Must Have Skills/Attributes:
Call Center, Customer Service Experience Desired: Bilingual in
Spanish required (2 yrs); Call center or customer service
experience required (Healthcare preferred) (2 yrs) Required Minimum
Education: High School Diploma or equivalent Job Description Work
Model: • Fully Remote (Must reside near Fulton, MD) • Bilingual in
Spanish required Required Education: • High School Diploma or
General Education Development (GED) Required Qualifications: •
Minimum two (2) years of call center or customer service experience
required (Healthcare preferred) • Excellent written and verbal
communication skills. Demonstrated analytical and problem-solving
skills. Working knowledge of systems used within the MSCC.
Additional Job Requirements: • Workers are expected to be in
attendance daily during/after training • Training will be 3 months.
No time off will be approved • No time off during training and/or
first 90 days of assignment • No time off during training, nesting
and/or first 90 days of assignment. This includes doctor’s
appointments. Three attendance violations during training/nesting
can and will result in early termination. • Must be flexible to
work weekends and a late shift • Internet must be hardwired (no
Wi-Fi accepted) • Must have strong internet speed and a quiet place
for remote work Shifts during training and nesting as well as
production operation hours: Fulton- 08/11 (Supporting MAS Region) •
Training: 8:00 AM - 4:30 PM EST • Nesting: 8:30 AM – 5:00 PM EST
Production Operation Hours: • Will be required to work nights and
weekends as late as 9:30 PM for all locations. Shifts are
determined by business need once training is completed. Internet
Requirements: • Internet must be hardwired (no Wi-Fi accepted) •
Must have strong internet speed and a quiet place for remote work
Summary : The Customer Service Representative is responsible for
increasing customer satisfaction and retention by providing
members, customers, patients, and providers with accurate,
consistent, timely, and meaningful information. They will provide
support to members'' inquiries and issues as they utilize the
Client plan and provider services, continuing to build rapport and
collaborative relationships with current and prospective members in
accordance with compliance guidelines. Major Responsibilities /
Essential Functions: • Available to handle member inquiries
regarding: • Member Core: Facility Inquiry, Web Support, Promote
Client, Order ID Card, Complaint, ID Card Inquiry, Service Review.
• Member Advance: Eligibility Inquiry, Benefit Inquiry, General,
Complaint, Correspondence Inquiry, Add/Remove Dependent, Service
Review, New Member Experience, Internal Regional Request, IVR
Defaults. • Medicare (For up to two (2) regions). • Premium Billing
Enterprise: Billing Inquiry, Make Payment, Complaint, EFT Inquiry,
General, Reinstatement Request, Service Review. • Client Billing,
1095 Tax Form, SLP (escalations to Tier 3). • Represents Health
Plan by answering and documenting all incoming contacts to
determine their nature and to respond to complex calls related to
specialized product lines or queues. • Responds professionally to
inquiries from internal/external customers. • Promotes, ensures,
and provides customer service to internal/external customers by
demonstrating skills consistent with the organization's philosophy
of providing extraordinary customer relations and quality service.
• Initiates contact with the appropriate Health Plan, medical
group, and facility personnel to obtain information relevant to the
concern or inquiry as needed. • Evaluates data to determine and
implement the appropriate course of action to resolve the complaint
and/or coordinate service recovery. • Documents conversations with
members according to procedure. • Follows established procedures to
meet customer/member needs. • Required to effectively interact with
diverse work units and relevant organizational departments. • Has
substantial understanding of the assigned skills and applies
knowledge and skills to complete a wide range of tasks. • Ability
to understand relevant policies, processes, and customers. •
Assists the department in meeting customer needs and reaching
department expectations. • Completes required training and
understands how to use tools available to recall necessary
information. • Develops a full awareness of the way performance and
actions affect members and Member Service Contact Center's (MSCC)
performance guarantees (call handling, first call resolution,
complaint resolution compliance, member retention, and return
contact as warranted). • Consistently supports compliance and the
Principles of Responsibility (Client Code of Conduct) by
maintaining the privacy and confidentiality of information and
protecting the assets of the organization. • Performs other
relevant duties as required. Only those lawfully authorized to work
in the designated country associated with the position will be
considered. Please note that all Position start dates and duration
are estimates and may be reduced or lengthened based upon a
client’s business needs and requirements. Benefits: For information
and details on employment benefits offered with this position,
please visit here. Should you have any questions/concerns, please
contact our HR Department via our secure website. California Pay
Equity: For information and details on pay equity laws in
California, please visit the State of California Department of
Industrial Relations' website here.
Keywords: , Vineland , Customer Service Representative. Member Services Call Center, Customer Service & Call Center , Fulton, New Jersey
