Under the direct supervision of the operations supervisor, the customer service representative is responsible for responding to a diverse membership and their providers as well as other customers in a timely, professional and courteous manner. This includes inbound and outbound member and/or provider phone calls or correspondence regarding benefit, eligibility or customer issues. Makes outreach welcome calls to new members and conduct Health Risk Assessment Surveys as needed. Provides member education and assists members with PCP selection and assignments. Assists with access to care and wellness program. Follows internal processes and procedures to ensure all activities are performed in accordance with departmental and company policies and procedures.
Demonstrate passion for providing superior customer service to our customers and continually seeks to understand the needs of those we serve.
Create accurate and timely member documentation concerning all inquiries taken in accordance to established protocols to ensure resolution is provided and presented in a clear and accurate manner.
Present and project a positive image of the company in and out of the office to fellow associates, members, providers and the community by being courteous, helpful, energetic, respectful and polite.
Strive to resolve an inquiry on first contact while ensuring that the inquiries have been addressed to the customer's satisfaction by using all resources in an efficient and timely manner.
Provide feedback and/or solutions to supervisor to ensure continuous process improvement and provide a better customer experience.
Creates and supports an environment which fosters teamwork, cooperation, respect and diversity.
Maintain an awareness of all product knowledge information.
Able to respond positively to support change within the department and the company.
Willing to be flexible regarding job responsibilities and schedule, not limited to but including, overtime and holidays, as a result of contractual business requirements.
Routinely meet or exceed contact center key performance indicators.
Perform other duties as assigned.
1 year prior customer service experience required.
Call center experience taking in-bound and/or out-bound calls preferred but not required.
Prior experience in the healthcare or managed care industry preferred but not required.
High School diploma or GED required.
Minimum 45 wpm typing skill preferred.
Excellent judgment and decision-making skills in dealing with complaints and sensitive requests required.
Ability to use PC applications in a MS Windows based.
Hours: 20 hours per week
Amerihealth Caritas Health Plan