Customer Service Rep, Remote
Customer Service Rep, Remote
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Job Description
Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and community service striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
The Customer Service Professional (CSP) acts as the primary point of contact for our members providers and other key stakeholders focusing on exceptional customer satisfaction and first call resolution.The CSPs interact with customers to provide information and troubleshoot complex issues in response to inquiries about coverage benefits services and to handle and resolve complaints.
The person in this role must be committed to building customer confidence and increasing customer satisfaction by delivering to callers an exceptional experience focused on quality and accuracy.
The CSPs will be initially trained on member demographic changes and benefit inquires. Additional member claims training will be delivered 60 days after CSP has completed benefits and eligibility training.
After successfully demonstrating core competencies by meeting or exceeding key performance measurements the individual will be trained to handle Provider claims inquiries as business needs dictate
Qualifications
High School Diploma or Equivalent required or Associates Degree Healthcare Management preferred
Primary Responsibilities:
- Serve as the primary liaison for members and providers for all lines of business including MassHealth and Commercial members regarding general program inquires such as eligibility verifications authorizations referrals claims material fulfillment address changes and Primary Care Physician assignments as well as member related policy and procedures.
- The CSP must be able to handle and demonstrate skills in handling benefits claims and eligibility calls for the member and provider population.
- Identify customer issues/concerns rapidly and precisely
- Research required information using available resources and triage when necessary
- Handle and resolve customer inquiries and complaints exhausting all efforts within the CSPs scope before requesting assistance
- Identify and escalate priority issues in order to create efficiencies
- Initiates follow up customer calls where necessary
- Complete call logs to record customer interactions and transactions recording details of inquiries complaints and comments as well as actions taken
- Refer customer grievances and appeals to designated departments for further investigation
- Responsible for navigating multiple systems in order to resolve customer issues
- Act as the primary representative for Mass General Brigham Health Plan for our customers focusing on first call resolution and customer engagement.
- Anticipates and meets or exceeds internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.
- Maintain Customer Service Behavior Competencies
- Communication
- Flexibility/Adaptability/Willingness/Team Player/ Positive Attitude
- Relationship Building/Caring
- Service Excellence/Accountability/Critical Thinking
Additional Job Details (if applicable)
- 10/20/25 Start Date
- 1 Month Training schedule: 8:30 AM 5:00 PM Mon Fri EST.
- Post Training Schedule:
- 9:00 AM 5:30 PM (Mon Tue Wed and Fri) with 11:30 AM 8:00 PM (Thurs) (EST)
- 9:30 AM 6:00 PM (Monday-Friday) (EST)
This role is fully remote (including training) a quiet secure stable HIPPA compliant work station is required
Remote Type
Work Location
Pay Range
$19.42 - $27.74/HourlyGrade
3EEO Statement:
Mass General Brigham Competency Framework
At Mass General Brigham our competency framework defines what effective leadership looks like by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance make hiring decisions identify development needs mobilize employees across our system and establish a strong talent pipeline.
Employment Type
Full Time
