Company :Highmark Bcbsd Inc.Job Description :
Handles customer inquiries by telephone and/or email and/or in person from individual members, groups, providers and brokers in a customer service center. Troubleshoots and resolves customer complaints. Ensures that responses to inquiries are completed timely and according to established service and quality standards.
This section lists the major duties and responsibilities of the position.This is not an exhaustive list of all job duties/functions/attributes.Depending on Role, essential responsibilities may also include oversight and management of people and functions described below.
1.Resolves customer inquiries and complaints via written, telephonic and face-to-face communication in a timely and accurate manner.
2.Prepares adjustments for services not properly processed, either systematically, or by forwarding to the appropriate area for follow up and resolution.
3.Meets all production, quality, and adherence standards. Attends all required training classes.
4.Elevates issues to next level of supervision, as appropriate.
5.Maintains accurate records, including timekeeping records.
6.Other duties as assigned or requested.
Education, Licenses/Certifications, and Experience (For Experience requirements please see appropriate role/level guide. If not applicable, list experience requirements below.)
Describe in objective and non-comparative terms the minimum education level, previous experience, specific knowledge skills and abilities the individual must have to perform the job.
High School Diploma or GED required for all levels
1-2 years customer service experience in a call center preferred with healthcare customer service strongly preferred
Knowledge, Skills and Abilities (This section describes additional preferred characteristics)
Knowledge of principles and processes for providing customer service, including customer needs assessment and meeting standards.
Ability to handle many tasks simultaneously and respond to customers and their issues promptly and professionally.
Ability to take direction and to navigate through multiple systems simultaneously.
Ability to maintain composure under stressful and fast-paced conditions.
Strong written and verbal communication skills
Ability to communicate complex information in a simple, customer facing way
IV. SCOPE OF RESPONSIBILITY (People Management Responsibility)
Does this role supervise/manage other employees? No Yes
If yes, indicate the number of direct reports:
V. WORK ENVIRONMENT
Most company positions are performed in a normal office environment. Please use this section to describe unusual work conditions, such as exposure to high noise levels, temperature extremes, etc. If "none, "please indicate with "Not Applicable."
Is Travel Required?
Unusal Working Conditions
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This job requires the ability to work as a team member. Additionally, this job requires the willingness and ability to report to work on a regular and timely basis and may require irregular work hours, holidays and/or weekends.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
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