Apex Systems | Customer Service Representative | san antonio, tx
3 weeks ago
Customer Service Representative
As a Customer Service Representative, you'll compassionately deliver an exceptional experience to between 50 to 70 callers per day. You will be responsible for conducting intake services from internal and external correspondence through telephonic inquiry. In addition to conducting telephonic outreach services, this position assists in benefits redetermination status for DSNP patients. You will support the Economic Security Assistance Department in assisting low-income Medicare beneficiaries with the qualification and application process for Medicare Savings Programs and redetermination.
Primary Responsibilities:
- Conduct intake services from incoming correspondence, telephonic inquiries, and telephonic outreach activities. Analyze and assess state Medicaid eligibility criteria for enrollment in Medicare Savings Programs and Health DSNP eligibility and status.
- Research complex issues across multiple databases and work with support resources to resolve member issues and/or partner with others to resolve escalated issues.
- Maintain assigned caseload and accurately input and maintain a contact database.
- Own problems through to resolution on behalf of the member in real-time or through comprehensive and timely follow-up with the member customers.
- Communicate effectively with elderly individuals and state and government personnel as well as other internal departments.
- Handle escalated calls, resolving more complex member issues in a one-and-done manner.
- Answer incoming phone calls from members and identify the type of assistance the member needs.
- Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems.
- Educate members on the State eligibility process and keeping their certification current.
- Maintain customer and organization confidentiality at all times.
- Perform all other related duties as assigned.
Required Qualifications:
- High school diploma / GED (or higher).
- 1+ years of Customer Service Representative (CSR) experience.
- Bilingual (English/Spanish) language proficiency.
- Proficient in Microsoft Word (creating and editing documents), Microsoft Excel (creating and editing tables), and Microsoft Outlook (email and calendar management).
- Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications.
Preferred Qualifications:
- 1+ years experience with adult Medicaid programs and CMS guidelines.
Soft Skills:
- Ability to demonstrate customer service and proper telephone etiquette.
- Strong oral and written communication skills.
- Solid listening, critical thinking, decision-making, telephone, customer service, and problem-solving skills.
Physical Requirements:
- Ability to sit for extended periods of time.
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