Humera - Administrative and Professional Staffing

Health Plan Specialist II

Minnetonka, MN, United States
Contact For Rate
Sep 25, 2017
Sep 30, 2017
Job Type
Employment Status
Full Time
Humera is looking for multiple Health Plan Specialist IIs for our client, a major healthcare provider, in Minnetonka, MN. This entry-level position is responsible for managing all inquiries from active, terminated, and prospective members of the health plan.
The Health Plan Specialist II is a primary contact for members to resolve service problems for claims, enrollment, billing, pharmacy as well as interpreting contracts and explaining benefits. They are responsible for exceptional levels of service satisfaction, providing quality service, and the service recovery process. The service recovery process is critical to the success of the department. The Health Plan Specialist II will use this process to assist members in complex situations.

The degree of client satisfaction and retention our client achieves with membership is directly related to the success of the customer service teams. The Health Plan Specialist II is responsible for identifying, researching and resolving member and all other internal and external customer concerns, problems and issues in a timely and courteous manner.

The Health Plan Specialist II's typically interact with a number of external and internal customers. External customers include the following: active, terminated, and prospective customers (providers and third-party administrators). Internal customers include: employees in medical management, enrollment, billing, claims, sales/marketing and legal. Outside vendors may include: pharmacy benefits managers, behavioral health and dental providers.
This is a long-term contract opportunity with the possibility of contract to hire.

  • Identifies, researches and resolves member and all other internal and external customer concerns, problems and issues in a timely and courteous manner
  • 90% answering inbound calls
  • 10% research and follow-up of unresolved calls

  • Associate's degree or equivalent work experience required. Bachelor's degree preferred
  • 1-2 years customer service experience required
  • Team interaction and support of each other in dealing with customer issues
  • Excellent verbal and written communication skills
  • Advanced ability to multi task and manage time efficiently is needed
  • An ability to identify process improvements, provide mentor and peer feedback and develop knowledge of multiple products and platforms is required
  • Provide mentor and peer feedback
  • Demonstrated ability to learn quickly and respond well to a rapidly changing industry and operational environment
  • Ability to calmly and effectively handle escalated calls

  • 6 weeks of training
    8:00 am to 5:00 pm
    Attendance is required

  • Regular hours:
    8:00am- 4:30pm
    9:30 am - 6:00pm

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