Job Summary

　　Inbound call center to assist and educate members, employer groups, providers, colleagues, and/or agents of health plan benefits with accessing services, facilitating and resolving problems, understanding claims, billing and coding, along with other questions. Consistently create an exceptional experience with each contact, via inbound and outbound calls, face-to-face interactions, online chat, email, etc.

　　Essential Functions

　　Analyzes, evaluates, resolves and responds to service inquires from members, providers, employer groups, colleagues, agents, Elite agents (customers), and others within departmental guidelines. Professional and pleasant interactions are ongoing expectations.

　　Partnering with internal and external resources, promptly provides customers with information and education concerning benefit clarification, eligibility requirements, verification, authorization, billing and claim status.

　　Promptly identifies and resolves or escalates customer concerns or complaints to achieve positive outcomes. Places outbound welcome calls to members to educate them on their benefits as needed. Assists walk-in members and agents if assigned by leadership.

　　Adheres to established procedure and quality guidelines in support of Priority Health service promise, key drivers, performance indicators, as well as Corporate values and codes of excellence. Identifies potential trends or issues that impact health plan members and works with coworkers and leadership resources to suggest process improvements.

　　Assists members with administrative issues, such as submitting enrollment record changes, providing letter explaining coverage or benefits, and obtaining and relaying certain member information to other departments as needed.

　　Facilitates claims resolution through follow-up on member calls and correspondence received to appropriate departments.

　　Effectively tracks and/or documents all service interactions with customers within appropriate systems according to guidelines.

　　Develops and maintains behaviors of productivity, availability to customers, and adherence to work schedule.

　　Qualifications

　　Required High School Diploma or equivalent

　　Preferred Associate's Degree

　　1 year of relevant experience in related field Required

　　Physical Demands

　　Pallet to Waist (6" from floor) > 5 lbs: Seldom up to 10 lbs

　　Waist to Waist > 5 lbs: Seldom up to 10 lbs

　　Waist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbs

　　Waist to Overhead > 5 lbs: Seldom up to 10 lbs

　　Bilateral Carry > 5 lbs: Seldom up to 10 lbs

　　Unilateral Carry > 5 lbs: Seldom up to 10 lbs

　　Pushing Force > 5 lbs: Seldom up to 20 lbs

　　Pulling Force > 5 lbs: Seldom up to 15 lbs

　　Sitting: Frequently

　　Standing: Occasionally

　　Walking: Occasionally

　　Forward Bend - Standing: Seldom

　　Forward Bend - Sitting: Occasionally

　　Trunk Rotation - Standing: Seldom

　　Trunk Rotation - Sitting: Occasionally

　　Squat: Seldom

　　Stair Climbing: Seldom

　　Reach - Above Shoulder: Seldom

　　Reach - at Shoulder or Below: Seldom

　　Handling: Occasionally

　　Forceful Grip > 5 lbs: Seldom

　　Forceful Pinch > 2 lbs: Seldom

　　Finger/Hand Dexterity: Frequently

　　Visual Acuity ¹ [None = No; Seldom = Yes]: Seldom

　　Primary Location

　　SITE - Lakeland Hospital St Joseph - 1234 Napier Ave - St Joseph

　　Department Name

　　Contact Center - CHS

　　Employment Type

　　Part time

　　Shift

　　Variable (United States of America)

　　Weekly Scheduled Hours

　　0.04

　　Hours of Work

　　Varies

　　Days Worked

　　Varies

　　Weekend Frequency

　　Every other weekend

　　CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

　　Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

　　Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

　　An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

　　You may request assistance in completing the application process by calling 616.486.7447.

　　People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people—including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities—and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.