Bilingual Member and Provider Services Representative
Bright HealthCare, Azerbaijan

• Partner with Bright members and providers to research and resolve escalated and complex member or provider issues, by phone, over chat, or in person
• Assist in researching, resolving and responding to social media escalations
• Collaborate across the organization to resolve complicated issues including, Claims, Enrollment, Billing, Provider Relations, Utilization Management, Sales, Broker Services, and all vendors
• Retain at risk members
• Complete outbound call campaigns to welcome members, check in with members, build connection, and address special risk issues (Out of Network utilization, wellness opportunities), etc
• Properly recognize and triage complaints, grievances and appeals in a timely manner
• Develop additional processes to further connect with the Bright Health members and providers
• Participate in the development and maintenance of policies and procedures relative to Customer Experience
• Assist in training of front-line Member and Provider Service Staff
• Complete various outbound call campaigns such as Welcome Calls, Check-In Calls, Special outbound call projects for high-risk members or providers
• Serve as a listening post to understand the voice of the Bright Health Customer and contribute ideas to improve the experience

• High School diploma or GED required, Bachelor’s Degree preferred
• Three (3) or more years of health insurance payer experience
• Three (3) or more years of direct customer service support

• Must have strong communication skills (verbal and written)
• Must be highly organized and be able to prioritize work to meet deadlines
• Must be successful working in an environment of ambiguity and change
• Display strong strategic behaviors such as initiative, problem solving, critical thinking, judgment, innovation and independence
• Ability to influence and collaborate with business partners throughout the organization.

Job Rewards and Benefits