Customer Service Representative, Remote

About HPI

At HPI, we are a forward-thinking, national third-party administrator (TPA) specializing in self-funded health plan solutions. With over 44 years of industry expertise, our entrepreneurial spirit, flexible approach, and personalized service have empowered us to serve clients of all sizes across diverse industries. We deliver innovative strategies that maximize the value of every healthcare dollar.

The self-funded health plan landscape is constantly evolving. At HPI, our partners benefit from having a TPA with the expertise, resources, and creativity to deliver customized plan solutions that help them win and retain more business. We excel at driving costs down and managing risk, while enhancing our clients’ employees’ health insurance experience. Our goal is to help members clearly understand their health plan and provide responsive service, enabling them to fully utilize their benefits and achieve greater health.

Our commitment extends beyond our clients to our own employees. We foster a supportive and inclusive work environment where innovation thrives. By investing in our team’s growth and well-being, we ensure they are equipped to provide exceptional service. 

Summary:

The Customer Service Representative is responsible for providing high quality customer service to members, providers and other customers of Health Plans, Inc. The Customer Service Representative handles inbound calls regarding questions on medical, dental and other benefits.

Customer Service Representatives are responsible for ensuring full resolution of customer issues presented. This includes referring issues to other internal teams as needed.    Customer Service Representatives are expected to uphold the quality and integrity of the relationship between Health Plans, Inc. and its clients and to meet the standards and expectations set forth by the Customer Service Department.

Duties and Responsibilities (other duties may be assigned):

• Effectively and professionally handle inbound customer inquiries
• Meet department standards and expectations for quality and production
• Accurately document all customer inquiries
• Place outbound calls as needed to resolve customer issues
• Maintain confidentiality of customer information
• Efficiently leverage tools and technology to support resolution of issues
• Work with partner departments to resolve customer issues
• Actively participate in and support the learning process

• Serve as a positive team member working toward a common company goal

Minimum Education Requirements (must have documented proof*):

• High School Diploma or equivalent

Minimum Experience Requirements:

• Experience in healthcare industry a plus

Preferred Education Requirements:

• Bachelor’s Degree or equivalent work experience preferred

Preferred Experience Requirements:

Attention to Detail: Be able to adhere to daily schedule; use available resources to stay on top of most current information; be able to organize and access proper reference materials and resources quickly and efficiently; clearly and accurately documents all customer inquiries.

Communication: Demonstrate appropriate telephone etiquette skills; effectively communicate to customers Health Plans’ policies, procedures and benefits.

Decision-Making: Follow department workflows for customer calls; display sound judgment and common sense when solving problems; handle emotional situations, cope effectively with a level head and defuse anger when necessary.

Flexibility: Embrace change as a worthwhile opportunity rather than an imposition; value diversity and accept others’ styles.

Passion for Service: Consistently maintain a professional and courteous demeanor even during challenging interactions; demonstrate a willingness to “go the extra mile;” position information positively and avoid negative wording during customer interactions; demonstrate empathy when appropriate.

Team Player: Be part of a team and contribute to a positive team atmosphere; interact with other staff in a professional manner that shows a respect for their contribution; work together with peers as a cohesive team toward common goals; be a positive representation of Health Plans.

Computer Skills:

• Proficient in Microsoft Office, including Word, Excel, Outlook and PowerPoint
• Technical/Functional Knowledge: Multitask effectively throughout the day; explain and interpret Health Plans’ policies and procedures based on available information; possess basic skills and understanding of PC, computer hardware/software and operations including most Microsoft applications; comfortable with technology.

Reasonable Accommodation:

Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the duties and responsibilities of the position.

Working Environment/Physical Demands:

The work environment characteristics and physical demands described here are representative of those an employee may encounter while performing the duties of this job.  

The noise level in the work environment is moderate.   The employee may occasionally lift and/or move up to 20 pounds.  Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.  While performing the duties of this job, the employee is regularly required to sit, walk, speak, or hear.  The employee is frequently required to use hands or feel or handle items as well as reach with hands and arms.  The employee is occasionally required to stand.