Member Services
CurrentResponds to member, provider and other inquiries via telephone, correspondence or lobby walk-in while meeting all corporate guidelines and performance standards.Demonstrates appropriate customer-care skills such as empathy, active listening, courtesy, politeness, helpfulness and other skills as identified.Records, investigates and resolves member complaints as detailed in the Grievance Procedure narrative.Assists in the education of new members and in the re-education of existing members regarding health plan procedures.Logs, tracks and appropriately documents all issues utilizing on-line systems and procedures, and in accordance with all applicable guidelines and requirements.Makes decisions that are consistent with the concept of a win-win-win for members, associates and WellCare.Demonstrates based behaviors such as initiative, accountability and value.Performs skills necessary to create a high-quality customer experience, as reflected through acceptable C-Sat scores, quality monitors and member feedback