Senior Client Support Specialist
2 weeks ago
Overview
Maximus is seeking a **Senior Client Support Specialist** to provide exceptional telephonic assistance within our Complaints Unit. This role is essential in evaluating reports of non-compliance by managed care organizations (MCOs) with relevant regulations and program standards.
The specialist will be responsible for investigating complaints from various stakeholders, including plan members and providers, regarding the administration and payment of Medicaid managed care benefits. Additionally, this position entails performing select processing duties and other administrative tasks as assigned.
This is an **ONSITE** position.
Compensation and Benefits:
- Starting pay: **$19.00/hr**
- Comprehensive healthcare benefits (medical, dental & vision)
- 401(k) retirement savings plan
- Paid time off (PTO)
- Holiday compensation
- Positive work/life balance
Key Responsibilities:
- Engage with clients and direct complaints or inquiries to the appropriate departments or representatives.
- Maintain up-to-date knowledge of managed care as it pertains to supported client programs.
- Follow established guidelines and protocols for complaint processing and handling sensitive information.
- Assist clients with health plan enrollment, disenrollment, and transfers as necessary.
- Complete tasks as directed by the Complaint Unit Supervisor or Project Management.
- Meet performance metrics outlined in the annual evaluation criteria.
- Address complex customer service inquiries and issues via telephone, documenting recurring problems for resolution.
- Potentially respond to inquiries via email.
- Prioritize customer service as the primary function, managing non-routine calls that require deviation from standard procedures.
- Adapt responses or conduct extensive research based on customer needs.
- Utilize computerized systems for tracking, information gathering, and troubleshooting.
- Handle escalated calls from less experienced representatives.
- Tackle moderately complex assignments, exercising judgment in resolving issues and recommending solutions.
Minimum Qualifications:
- High school diploma or GED required, along with 1+ years of relevant professional experience, or an equivalent combination of education and experience.
- Experience in a call center environment.
- Familiarity with medical billing.
- Proficiency in Microsoft Office Applications (Word, Excel, PowerPoint).
EEO Statement:
Maximus is committed to fostering a diverse workforce and provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.
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