• Research, review and respond to inquiries received from members and providers. • Employ active listening skills, demonstrate patience and empathy, and handle difficult calls tactfully, courteously, and professionally. • Effectively manage escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. • Leverage company policies and procedures, benefits, claims, and eligibility to respond accurately to all inquiries. • Handle member complaints and complaint appeals. • Work with internal departments, vendors, business partners, providers, etc. to help coordinate problem solving in an effective and timely manner. • Demonstrate basic understanding of company billing guidelines and effectively interpret inquiries related to claims and claim payments. • Accurately document all calls. • Recognize trends and patterns in call types and engage leadership with suggested solutions. • Meet and maintain established department production and quality standards, on both an individual and team basis. • Assist members with navigating the member portal while encouraging them to becoming self-sufficient with our tools. • Demonstrate personal responsibility and accountability by meeting attendance and schedule adherence expectations. • Effectively excel in a virtual work environment through active participation in team huddles, supervisor 1:1s, instant messaging, and check-ins.