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Customer Services Representative
2 months ago
Min Hourly Rate($): 19.57
Max Hourly Rate($): 19.57
***Only qualified Customer Service Representative candidates located near the Fulton, MD area will be considered***
Qualifications:
• HS Diploma or GED required
• Minimum two (2) years of call center or customer service experience required (Healthcare preferred)
• Candidates have to be within 30 miles of Fulton, MD location
The Customer Service Representative is responsible for increasing customer satisfaction and retention by providing members, customers, patients and providers with accurate, consistent, timely and meaningful information. They will provide support to members' inquiries and issues as they utilize the Client plan and provider services, continuing to build rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines.
Major Responsibilities and Functions:
• Available to handle member inquiries regarding: Member Core: Facility Inquiry, Web Support, Promote Client, Order ID Card, Complaint, ID Card Inquiry, Service Review. Member Adv.: Eligibility Inquiry, Benefit Inquiry, General, Complaint, Correspondence Inquiry, Add/Remove Dependent, Service Review, New Member Experience, Internal Regional Request, IVR Defaults. Medicare (For up to two (2) regions.).
• Premium Billing Enterprise: Billing Inquiry, Make Payment, Complaint, EFT Inquiry, General, Reinstatement Request, Service Review, Client Billing, 1095 Tax Form, SLP* (escalations to Tier 3).
• Represents Health Plan by answering and documenting all incoming contacts to determine their nature and to respond to complex calls related to specialized product lines or queues.
• Responds professionally to inquiries from internal/external customers. Initiates contact with the appropriate Health Plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed.
• Evaluates data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery.
• Documents according to procedure. Follows established procedures to meet customer/member needs.
• Required to effectively interact with diverse work units and relevant organizational departments.
• Has substantial understanding of the assigned skills and applies knowledge and skills to complete a wide range of tasks. Ability to understand relevant policies, processes and customers.
• Assist the department in meeting customer needs and reaching department expectations.
• Completes required training and understand how to use tools available to recall necessary information.
• Develop a full awareness of the way performance and actions affect members and Member Service Contact Centers's (MSCC) performance guarantees (call handling, first call resolution, complaint resolution compliance, member retention, and return contact as warranted).
• Promotes, ensures and provides customer service to internal/external customers by demonstrating skills which are consistent with the organization's philosophy of providing extraordinary customer relations and quality service.
• Consistently supports compliance and the Principles of Responsibility by maintains the privacy and confidentiality of information and protects the assets of the organization.
• Performs other relevant duties as required.
Requirements:
• No time off during training and/or first 90 days of assignment.
• Must be flexible to work weekends and a late shift.
• Internet must be hardwired and no WIFI accepted
• Must have strong internet speed and a quiet place for remote work.
Additional Job Details:
• It is expected for workers to be in attendance daily during/after training.
• Training will be 3 months. No time off will be approved.
Shifts during training and nesting as well as productions operation hours.
Fulton- 9/9 (Supporting GA Region):
• Training: 8:00 AM - 4:30 PM EST
• Nesting: 8:30 AM – 5:00 PM EST
