Customer Service Representative

4 weeks ago

Washington, Washington, D.C., United States CODICE Full time
Job Description

At CODICE, we are seeking a skilled Customer Service Representative to join our team. As a key member of our customer service team, you will be responsible for assisting enrollees in selecting the most appropriate MCO and PCP, taking into account each individual's needs and location.

Duties and Responsibilities

  • Assist enrollees in selecting the most appropriate MCO and PCP
  • Answer questions and provide information and education on programs and services
  • Respond to requests, and/or take actions on accounts or enrollment applications
  • Follow standard procedures to ensure consistency, accuracy, and meeting all quality assurance requirements
  • Facilitate the conversation by soliciting needed information, clarifying responses, and addressing concerns
  • Manage customer inquiries with consistency, accuracy, and professionalism, displaying excellent customer service skills and extensive technical program knowledge
  • Follow scripted dialogues to ensure quality and maintain high accuracy rates
  • Regular and predictable attendance required

Knowledge, Skills and Abilities

  • Managing Work: Effectively managing time and resources to make sure that work is finished
  • Decision Making: Identifying and understanding issues; comparing information to make a choice; choosing a course of action carefully and wisely; taking action
  • Communication: Clearly expressing information and ideas through a variety of ways; helping individuals understand and retain the message
  • Contributing to Team Success: Actively participating as a member of a team to help the team complete goals
  • Work Standards: Setting high standards of performance for self and others; taking responsibility and accountability for successfully completing work
  • Customer Focus: Making customers and their needs a main focus; developing and keeping valuable customer relationships

Job Specification

  • Skill/Knowledge: Has substantial understanding of the job and applies knowledge and skills to complete a wider range of tasks
  • Job Complexity: Works on assignments that are moderately difficult, requiring judgment in resolving issues or in making recommendations

Required Education and Experience

  • High school diploma or equivalent
  • Two (2) years of customer service/call center experience or equivalent
  • Experience working with special needs populations and/or families of special needs children
  • Experience or training in a health care related field
  • Experience or training related to health care insurance, Medicaid, MCO/PCP selection, EPSDT services, and any other health care programs or similar programs administered in other states
  • Experience or training in the managed care industry
  • Experience using a personal computer and software programs and a TTY machine

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