Healthcare Call Center Representative Trainee
3 days ago
The Health Plan Call Center Rep Trainee will undergo comprehensive training to excel in a Call Center Rep 1 position.
This role requires providing exceptional, prompt, and courteous service to Cook Children's Health Plan Members and Providers in a fast-paced call center environment.
The Trainee will deliver quality services by responding to inquiries promptly and directing when possible or collaborating with other CCHP team members to ensure seamless delivery of care to Members and Providers.
Essential Job Functions:- Benefits/Eligibility/Member updates
- Enhance the customer experience by utilizing effective questioning and listening skills when interacting with Members and their authorized representatives, and skillfully resolving frustrated callers by identifying and finding solutions to Member issues.
- Follow all departmental policies and procedures and maintain confidentiality.
Educate and guide Members through the complexities of the programs using clear and concise instructions, and utilize available resources to help Members make informed decisions regarding their health.
Support efforts to assist Members with renewal requirements.
Core System:Update Member accounts with accurate PCP and demographic information.
Document all Member-related interactions using correct grammar and terminology into CCHP's core system for accurate tracking and analysis of data and trends.
Route and report identified trends with Providers to the management team.
Issue Resolution:Gather all relevant information regarding complaints/grievances and accurately document the Member's account.
Collaborate with other CCHP departments as needed to resolve Member complaints/grievances, ensuring timely information is sent to the Compliance Department.
Cultural Sensitivity:Utilize cultural sensitivity during interactions with Members.
Schedule face-to-face interpreters for non-English speaking Members for medical appointments.
Use CCHP's TTY hearing impaired phone or Texas Relay to communicate with hearing impaired Members.
Customer Service:Meet and maintain a score above 87% for Customer Service Call/Notes Accuracy, as monitored by the Quality Department.
Meet and maintain all approved phone metrics while delivering high standards of customer service.
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