Job Description





The primary goal of the Member Representative (MR) is to provide administrative support to our operations staff and to process uninterrupted inbound and outbound outreach phone calls to members in order to assess the probability of eligibility for Social Security benefits (SSI/SSDI) or MassHealth disability benefits by performing the following tasks. Responsibilities include but are not limited to: 








· Maintain a contact and outreach activities record thru the Contact Log of all work performed on specific cases. 


· Schedule, confirm and re-schedule SSI appointment for members. 


· Customize release forms on a per-claimant basis to collect member signatures. 


· Fax, scan, and file notices and documents as necessary.  


· Receive and process all L88 and other forms of decision notices. 


· Scan various SSA mail into member electronic record. 


· QC all forms received daily for accuracy. 


· Perform follow up outreach calls to members to obtain signed consent forms. 


· Process all incoming SS mail and distribute, including undeliverable mail returned to HFI and research alternative means of contact the member. 


· File all necessary SSA forms and documents into member file. 


· Process closed case files to offsite storage. 


· Process Case Manager Referrals thru the Cognito form system. 





· Document all call interactions according to company standard operating procedures.  


· Utilize internal data base to qualify calls and direct them to the appropriate department.


· Ability to work in a fast paced high volume contact center that handles multiple services within the healthcare industry and the
disability application process. 


· Ability to perform repetitive tasks accurately on a continuous basis under conditions of constant interruption and frequent


· Answer phone calls from members, SSA office, healthcare providers and MCO’s in a timely and effective manner by utilizing the provided script, and provide good customer service and problem solving when issues arise - phone etiquette. 


· Pleasant telephone voice and manner knowledge and ability. 


· Outreach to applicants who have not returned required paperwork and encourage them to return appropriate paperwork in order to
expedite claim.


· Ability to work in a high production, metrics driven contact center environment. 


· Respond to customer service issues within required timeframes to meet customer expectations.  


· Inform members of documentation required to process application, required time frames, potential entitlement information and status
either by phone and/ or written correspondence. 


· Educate members and his/her family on various entitlement programs and services offered by HFI. 


· Interact with members and his/her family to via telephone to acquire necessary information to move the application process along, as
established by management. 


· Participate in Department and HFI Committees and Projects as assigned by the Operations Manager/Supervisor.  


· Other duties may be assigned. 




· Associates Degree in related field or equivalent combination of education and experience, required.  


· Bilingual (English/Spanish), preferred.  


· At least 1 year of previous experience in a high call volume customer service/call center role, preferred. 


· At least 1 year of previous experience in a healthcare setting, preferred.  


· Planning and organizational skills necessary to coordinate workload around multiple assignments and clients.  


· Excellent written and verbal communication skills, articulate with active listening.  


· Ability to handle a high volume of calls in outreach efforts. 


· Self-motivated, responsible, accountable, attention to detail and superb organizational skills.  


· Strong emotional strength and maturity to deal effectively with a challenging and vulnerable population. 


· Ability to meet deadlines/goals while balancing competing demands and performance benchmarks. 


· Identifies own learning needs and seeks appropriate assistance from Manager/Supervisor.  


· Excellent computer skills including: proficient typing skills, MS Office, and data entry. 


· Ability to work well within a fast-paced, collaborative, cross-functional team environment. 


· Willing to work extra hours when necessary with short notice and maintain a flexible availability. 





HFI is strongly committed to diversity and inclusion. We recognize the rich variety of backgrounds, experiences and points of view of a diverse staff that enhances both the quality of the services we provide and the excitement and innovative spirit of our work culture.



We are committed to a policy of non-discrimination and equal employment opportunity for all employees and qualified applicants without
regard to race, color, religious creed, national origin, ancestry, sex, age, disability, veteran’s status, sexual orientation and/or genetic information.



Application Instructions

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