Customer Service Representative

4 weeks ago

Arlington, United States TalentBurst Full time
Title: Customer Service Representative
Location: Arlington, VA (100% remote)
Duration: 6 Months
Hours: Shifts vary between 11am-9pm EST Monday-Friday
Training: Monday - Friday 8:00am-4:30pm CST for 4-6 weeks

Job Description:
  • Customer Service Representatives (CSR's) will be working with and providing support to health plan members, providers and/or their representatives.
  • Leadership rewards and recognizes CSR's regularly for performance in an environment that challenges while providing clear direction and support to foster success in the role.
  • Answer and manage inbound inquiries regarding health plan benefits and claims, eligibility, medical and other healthcare procedures, billing and payments and other related topics from customers in a prompt, courteous manner.
  • Conduct outbound and/or return calls to customers, as necessary.
  • Ask appropriate questions and listen actively to identify specific questions or issues to provide appropriate response and type of assistance the customer needs while documenting relevant information in a clear and concise manner in computer systems.
  • Communicate and partner with customers tactfully and empathetically to resolve issues, using clear language translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can comprehend and act upon.
  • Handle and process customer complaints/grievances while applying appropriate conflict management skills to de-escalate potentially stressful situations.
  • Meet the performance goals established for the position in the areas of efficiency, accuracy, quality, member satisfaction and attendance.
  • Adhere to all applicable department, organization and/or regulatory policies and procedures.
  • Read, comprehend, and verbalize processes and procedures of the organization and of health insurance coverage.
  • Trainees will be required to attend the entirety of training, successfully complete the required training schedule, and demonstrate proficiency of the material at the end of training.
Description
  • Prefer individuals who can work on LATER shifts, candidates in PST would be ideal
  • If you have planned vacation or any other commitment that will prevent you from being able to complete the training class in full, then we ask you to consider another upcoming class when you can provide your full commitment
  • During training, you will be required to be on camera to simulate the classroom environment

Required Schedule & Hours
  • Includes a virtual classroom environment with trainers who have experience working within the Customer Service Operations (CSO) call center
  • Any extensive time missed in training may result in immediate termination of your contract
  • Due to the amount of information you will receive in training, 100% attendance is requried
  • If you miss more than 12 hours or more of training, you will be evaluated for release of your position
  • Regular/long term schedule:
The Experience You'll Need - Required
  • High school diploma or GED
  • At least 1 year call center experience
  • Ability to handle a heavy call volume of 50-100 calls daily
  • Demonstrated ability in using computer and Microsoft applications, which includes strong keyboard and navigation skills, ability to type 35 WPM and learn new computer programs
  • Ability to work regularly scheduled shifts within hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed
  • Demonstrated ability to take an educative approach, listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the customer, answering questions and informing of health plan policies, procedures, or decisions
  • Ability to maintain strict confidentiality of protected health information

Additional Experience that is Preferred
  • 2+ years at a health plan, TPA or related call center setting
  • Knowledge of managed care, Commercial, Marketplace, Medicaid and/or Medicare programs; knowledge of medical policy benefits and exclusions
  • Bilingual in Spanish & English (validated via bilingual assessment upon offer acceptance)
At Home Workspace Requirements:
  • This requires a quiet, private workspace without noise and distractions
  • Set aside a dedicated location within your home outside of common areas to avoid background noise while on calls with our members and/or providers
  • Please be sure that dependent and/or pet care has been resolved before you begin your new position
  • Working at home is not a replacement for daycare for children and/or pets
  • Your workspace must be able to always maintain privacy during your working hours
  • This means your area must be in a secured locked location free from any distractions or ability disclose HIPPA or PHI information
  • You may not work remotely in a public place (Coffee shop, park, library, airport, etc), which also includes outside of the country, including any US territory
  • If you need to work at a different location, this must be preapproved by your leader
  • Your equipment should not be moved from your home location without preapproval by your leader, as this runs the risk of loss of HIPPA and/or PHI information

New Hire CSO CSR Technology Requirements
  • All team members are required to have a smartphone so that they can access Microsoft Multi-Factor Authentication & Microsoft Teams
  • Due to the use of the NICE application for servicing our inbound and outbound calls, Client requires that all CSR team members have an internet service that provides 100 MBPS fiber optic, high speed service and must be able to connect directly to your router via an ethernet cord
  • The use of WIFI on your laptop will be disabled, as while using NICE will cause dropped calls, and inability to hear voice through your headset
  • The below internet services are NOT compatible with the NICE application and are, therefore, NOT acceptable for this role:
  • 4G, 5G, LTE or Satellite Internet service, as they are an escalated WIFI / Hot Spot service
Company Supplied Equipment for CSO CSR Agents
  • Dell Laptop/Small PC (dependent on current inventory)
  • Power cords
  • One large monitor
  • Keyboard/Mouse/Headset
  • 15-foot Ethernet cable
TB_PH

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