Retention Service Representative

Company: Health Net, Inc.
Location: Utica
Posted on: February 13, 2020

Job Description:

Description: Position Purpose: The Retention Service Advocate is responsible for retaining current membership at an assigned community office and must meet daily production metrics designed to achieve higher membership retention and satisfaction. The Retention Service Advocate assists, educates and resolves member inquiries by providing information about Fidelis Care products, services and policies and procedures. Assisting members in the renewal of their Fidelis Care coverage as well as enrolling prospective members the Retention Service Advocate must ensure compliance with all regulatory, audit and corporate policies. Position Competencies & Responsibilities: Customer Service: Answer product and/or service questions; suggest features and benefits about company products and services in order to provide current and potential customers with accurate, timely and thorough information. Answer application questions regarding the programs and services in order to maintain/attract membership. Conduct outreach and follow up calls to educate members about Fidelis Products and serves as a liaison between the member and the different Fidelis departments Sales Skills: Ability to undergo rigorous internal training and have complete command of the sales process, Fidelis Care products, competitive environment in their region and successfully pass a test (with a minimum 85% score) with no more than 2 attempts, which will indicate the applicants level of proficiency in these areas. Have the ability to conduct a needs based analysis to better understand the best course of action based on those needs and be able to answer product feature and benefit questions and provider network questions for members both within and outside of their region. Documentation - Service Details: Track, file, and input all technical documentation in order to ensure all customer accounts correctly reflect the activity that was performed. Complete all necessary documentation (i.e. customer comments, and follow-up actions) in order to maintain complete records of customer requests and inquiries. Input, update and create member information on databases in order to maintain customer accounts. Utilize computer systems to perform administrative functions such as FOCUS and FACETS. Troubleshooting Customer Problems: Clarify the customer's complaint; determine the cause of the problem; select and explain the best solution to solve the problem (if unable to handle directly, provide accurate guidance to correct department) and expedite correction or adjustment; follow up to ensure resolution. Research: Research misapplied payments, mail requests, billing adjustments, coverage status and other issues brought up by customers in order to resolve escalated issues efficiently and accurately. Customer Complaints: Listen patiently to customer complaints, probe and research information being provided and attempt to resolve difficult situations in order to ensure customer satisfaction; follow up with customers when appropriate. Member Relations: Develop and maintain relationships with existing members by providing guidance and assistance throughout the year. Demonstrate passion for members by identifying unfulfilled needs and providing necessary education and assistance to promote the value and benefits offered by Fidelis Care. Modify delivery skills accordingly to overcome objections and retain members. Identify solutions to issues and concerns. Other duties as required: Job performance requires fulfilling other incidental or related duties as assigned, assisting and training others, and performing duties of higher rated positions from time to time for developmental purposes.

Keywords: Health Net, Inc., Utica , Retention Service Representative, Sales , Utica, New York