Summary of Job: To provide high quality service to ConnectiCare members, acting as a customer advocate in providing high quality, accurate, concise, proficient and professional assistance.
Receives and responds to inquiries/issues from members, regarding benefits, coverage, payment, coding and health service policies and procedures.
Simultaneously log all inquiries in call tracking system accurately with content and description of question/issue and resolution.
Collaborates with all departments throughout the organization to identify issues or areas of concern for members.
Researches and analyzes recurring trends, problems and complaints to determine root cause; recommends solutions and/or resolutions.
Provides instruction/education to members, ConnectiCare Policies and Procedures.
Follows through with callers when inquiries/issues cannot be resolved on first contact.
Displays a positive attitude and embraces our call center vision to be member focused.
Performs other related projects and duties as assigned.
Post High School education/training or equivalent combination of education and experience
At least 2 year's of previous customer service experience, highly desired in a medical environment or call center environment
Knowledge medical terminology and coding strongly preferred
Excellent oral, written and interpersonal communication skills required
Previous system user experience in a fast paced highly automated environment required
Strong PC skills required
Demonstrated organizational and problem solving skills
Excellent telephone manner; ability to handle high call volumes efficiently and courteously
Ability to perform in office environment with extended periods of sitting, using telephone, viewing computer screens, standing, reaching, lifting files, binders, computer reports
Bi-lingual Spanish speaking desired
Essential Job Requirements:
Must be able to use standard office equipment.