Long Term Care Customer Service Representative I/II/III

1 week ago


Rochester, United States Excellus BlueCross BlueShield Inc Full time
Job Description:

Summary

The LTC Customer Service Representative resolves customer inquiries via telephone, mail, fax, and email concerning, but not limited to, policy benefits, claim payments, benefit reductions and billing. The LTC Customer Service Representative provides service for customers and business partners while responding in a professional, efficient, and timely manner to resolve issues and enhance customer satisfaction.

Essential Accountabilities:

All Levels

•Provides service among the customers and business partners while responding in a professional, efficient, and timely manner to enhance customer satisfaction. Must exercise tact, patience, and professionalism always in responding to internal/external customers.

•Documents, researches, interprets, and responds to inquiries from internal and external customers, and business partners concerning our products, services, and policies in accordance with HIPAA and other legislative requirements.

•Utilizes appropriate resources to resolves customer inquiries accurately & efficiently, resulting in acceptable quality, and performance.

•Participates in meetings, training, and skill development to support career path and individual development plans.

•Identifies and follows through on issues impacting MedAmerica and customer experience.

•Develops effective internal working relationships for improved communication and collaboration.

•Shares ideas and solutions to improve processes, procedures, and systems.

•Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and Leading to the Lifetime Way values and beliefs.

•Maintains high regard for customer privacy in accordance with the corporate privacy policies and procedures.

•Regular reliable attendance is expected and required.

•Performs other functions as assigned by management.

Level II (in addition to Level I accountabilities):

•Handles moderately complex customer and agent calls, resolves issues with minimal supervision.

•Accurately interprets individual and group policies and procedures to provide clear and accurate information to customers.

•Consistently demonstrates the ability to meet and exceed service metrics.

•Provides support to peers and leadership with regular operational administrative work.

Level III (in addition to Level II accountabilities):

•Handles complex customer and agent calls with limited supervision.

•Assists with complex projects assigned by leadership that require advanced problem-solving skills.

•Assists with training and mentors other team members in all areas of Customer Service and supports new hires and peer group.

•Executes assigned tasks timely and accurately and any subsequent follow up needed.

•Organizes and completes daily operational administrative work.

•Provides escalation support for level I & level II calls.

Minimum Qualifications:

NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.

Level I:

•High School diploma or GED.

•Customer service experience preferred.

•Knowledgeable in all aspects of Customer Service, including PC Network application, benefit interpretation, processing procedures, administrative support to agents and customer relations skills.

•Demonstrates willingness to adapt and be flexible to changes and business needs while taking ownership and accountability for issue identification and resolution.

•Ability to multi-task to efficiently resolve customer concerns, by actively listening to the customer, navigating screens on the computer, typing call documentation, and speaking to the customer simultaneously.

•Excellent computer skills, including the ability to navigate in a Windows environment. Skillful at working between multiple programs and applications at the same time.

•Adept at communicating effectively and diplomatically while working as a collaborative team member.

•Strong reasoning skills with the ability to troubleshoot and problem solve.

•Strong organizational skills and ability to prioritize, and work in fast paced environment and remain professional and focused under multiple pressures and demands.

Level Il (in addition to Level I qualifications)

•Two (2) years' experience in a level I Customer Service Representative role.

•Associates degree in Business Administration, Health Care Administration, Health Economics or related. In lieu of degree, minimum of three (3) year of outside customer service experience required.

•Ability to efficiently resolve complex & escalated issues with minimal direction.

•Advanced system and navigational skills.

•Advanced communication skills with the ability to effectively communicate across multiple channels.

Level III (in addition to Level II qualifications)

•Two (2) years' experience in a level II Customer Service Representative role

•Ability to multi-task and self-sufficient in resolving complex & escalated issues. Demonstrated ability to think globally and takes initiative to recognize opportunities within the team.

•Demonstrates comprehensive knowledge and understanding of all policies to act as a resource for Level I and Level II colleagues.

•Experience with training or mentoring colleagues.

•Self-directed with the ability to deliver job tasks and projects within a deadline.

Physical Requirements:

•Work is completed in a normal office environment under fluorescent lighting.

•Ability to use a headset to listen to customer conversations required.

•Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time.

One Mission. One Vision. One I.D.E.A. One you.

Together we can create a better I.D.E.A. for our communities.

At the Lifetime Healthcare Companies, we're on a mission to make our communities healthier, and we can't do it without you. We know diversity helps fuel our mission and that's why we approach our work from an I.D.E.A. mindset (Inclusion, Diversity, Equity, and Access). By activating our employees' experiences, skills, and perspectives, we take action toward greater health equity.

We aspire to reflect the communities we live in and serve, and strongly encourage people of color, LGBTQ+ people, people with disabilities, veterans, and other underrepresented groups to apply.

OUR COMPANY CULTURE:

Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Equal Opportunity Employer

Compensation Range(s):

Level I: Grade 108: Minimum $18.55 - Maximum $26.90

Level II: Grade 109: Minimum $19.22 - Maximum $30.76

Level III: Grade 110: Minimum $20.02- Maximum $33.03

The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.

Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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