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Senior Client Support Specialist
2 months ago
Overview
Maximus is seeking a Senior Client Support Specialist to provide exceptional telephonic assistance within our Complaints Unit. This role involves assessing allegations of non-compliance by managed care organizations (MCOs) with regulatory and program requirements set forth by the Department of Health.
The selected candidate will be responsible for investigating complaints from various stakeholders, including plan members and providers, ensuring a thorough examination of issues related to Medicaid managed care benefits. Additionally, this position encompasses specific processing tasks and administrative responsibilities.
This is an ONSITE role.
What We Offer:
- Starting pay: $19.00/hr
- Comprehensive healthcare benefits (medical, dental & vision)
- 401(k) retirement savings plan
- Paid time off (PTO)
- Holiday compensation
- Supportive work/life balance
Key Responsibilities:
- Engage with clients and direct complaints or inquiries to the appropriate departments or representatives.
- Maintain current knowledge of managed care practices relevant to supported programs.
- Follow established guidelines and protocols for complaint processing and handling sensitive information.
- Assist clients with health plan enrollment, disenrollment, and transfers as needed.
- Complete tasks as directed by the Complaint Unit Supervisor or Project Management.
- Meet performance metrics as outlined in the annual evaluation criteria.
- Address complex customer service inquiries and document recurring issues for resolution.
- Respond to email inquiries as required.
- Prioritize customer service, managing non-routine calls that may require deviation from standard procedures.
- Adapt responses and conduct extensive research based on customer needs.
- Utilize computerized systems for tracking and information gathering.
- Handle escalated calls from less experienced representatives.
- Manage moderately complex assignments, exercising judgment in resolving issues and proposing solutions.
Minimum Qualifications:
- High school diploma or GED required, with a minimum of 1 year of relevant professional experience, or an equivalent combination of education and experience.
- Experience in a call center environment.
- Familiarity with medical billing processes.
- Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).
Equal Employment Opportunity:
Maximus is committed to creating 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.
