Customer Service Liaison

5 days ago


Wheeling, West Virginia, United States The Health Plan of West Virginia Inc Full time
Job Summary

The Customer Service Coordinator position at The Health Plan of West Virginia Inc is a key role that requires a high level of customer service expertise and technical knowledge. The successful candidate will be responsible for providing exceptional service to our members, responding to their inquiries, and resolving issues in a timely and professional manner.

Key Responsibilities:

  1. Customer Service: Provide top-notch customer service to our members, responding to their inquiries, and resolving issues in a timely and professional manner.
  2. Issue Resolution: Assess and resolve issues at the root cause level, and assist Customer Service Representatives with difficult situations.
  3. Monitoring and Auditing: Assist the Manager with monitoring and auditing Customer Service Representative calls to ensure high-quality service delivery.
  4. Correspondence: Respond to written correspondence in a timely, professional, and friendly manner.
  5. Task Prioritization: Prioritize multiple tasks and responsibilities to meet deadlines and deliver results.
  6. Communication: Record and communicate all information clearly and accurately, and maintain a positive, caring work relationship with others.
  7. Performance Metrics: Maintain a monthly monitoring score of 90% accuracy or above on the 17 points of excellence.
  8. Policy and Procedure Knowledge: Demonstrate a complete understanding of departmental policies and procedures.
  9. Autonomy: Perform tasks without supervision and meet requirements on annual performance evaluation.
  10. Training and Development: Assist with training and maintaining/updating shared training documents.

Requirements:

  1. Education: High School graduate or equivalent.
  2. Experience: Three years of call center experience.
  3. Skills: Self-starter, works independently, detail-oriented, good problem-solving skills, ability to prioritize and meet deadlines, consistently displays a positive attitude, excellent communication skills, easily adapts to changes in work requirements, knowledge of company software and equipment.
  4. Desired Qualifications: Associates degree or 4-5 years call center experience, knowledge of CPT and ICD 10 Coding, knowledge of medical terminology, knowledge of member benefits and health insurance concepts, must have knowledge of hospital and physician claims.


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