Call Center Service Reps – Hybrid/Remote! Training! Benefits! Career Path! $20.50/hr

Fallon Health, founded in 1977, is a leading health care services organization committed to supporting the diverse and evolving needs of its members. The company specializes in offering innovative health insurance solutions, including a comprehensive range of Medicaid and Medicare products. Distinguished by its excellence, Fallon Health is the only health plan in Massachusetts awarded “Excellent” Accreditation by the National Committee for Quality Assurance for its HMO, Medicare Advantage, and Medicaid offerings. This reputation underscores their commitment to quality care and innovative health programs.

Fallon Health designs unique health care programs that deliver coordinated and integrated care, particularly catering to seniors and individuals with complex health care needs. The organization thrives on expanding its services and products to meet both current and future industry demands, making it an exciting time for professionals to join its growing team.

The Member Services Representative role at Fallon Health offers a fantastic opportunity for individuals eager to be part of an expanding and reputable health care organization. This position provides a gateway to interact with nearly every facet of the company, including its products, services, departments, and personnel. In this role, you will serve as the initial and primary point of contact for members and providers, acting as an advocate and ambassador for the Fallon Health brand. You will address inquiries and troubleshoot issues with professional care, ensuring customer satisfaction and representing Fallon Health with integrity and compassion.

This is a hybrid opportunity that begins with approximately 8 to 9 weeks of on-site training in Worcester, MA, after which remote work may commence. Candidates must have strong typing skills with a minimum net typing speed of 25 words per minute. The company offers various day shifts to accommodate different schedules, with specific arrangements discussed during the interview process.

Apart from handling calls, Member Services Representatives are crucial in documenting call details accurately for monitoring purposes and identifying trends that may indicate broader enterprise service issues. Representatives are empowered to escalate concerns appropriately and exercise judgment within corporate policies to resolve member and provider needs effectively.

Fallon Health is proud to offer a comprehensive skill-based progression training program that includes blended learning and personalized coaching. This training ensures new hires develop the expertise and confidence necessary to excel in their roles. Furthermore, the company encourages career growth and advancement opportunities, with successful employees often moving into key areas such as Sales and Marketing, Provider Relations, Care Services, Pharmacy, and other critical operational functions.

This role is ideal for individuals with a passion for customer service and an interest in health care, seeking a dynamic work environment that values professional development and offers a supportive team atmosphere. Fallon Health is an equal opportunity employer dedicated to fostering diversity and inclusion in the workplace, ensuring a respectful and supportive environment for all employees regardless of race, color, religion, gender identity, or any other protected status by law.

In addition to the rewarding nature of the role, the pay for this position is set at $20.50 per hour, reflecting compliance with the Massachusetts Wage Transparency Act. Overall, joining Fallon Health as a Member Services Representative not only provides a meaningful career path but also the chance to work with a respected leader in the health care industry that prioritizes quality, innovation, and employee growth.