LE0002 MMM Holdings, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. MMM Holdings, Inc. Job Description BUSINESS UNIT: MMM Holdings, LLC DEPARTMENT: Service Operations Department - Call Center POSITION: Customer Service Representative REPORTS TO: Customer Service Supervisor CLASSIFICATION: Non Exempt POSITION DESCRIPTION This position is responsible to serves as primary liaison between enrolled beneficiaries, provider network and MMM & MSO, for the purposes of provide orientation, issues resolution, and provider satisfaction. ESSENTIAL DUTIES AND RESPONSIBILITIES Provides member/provider materials upon request; acts as primary liaison between both of them. Provides ongoing telephone orientation regarding policies and procedures to our members, providers or office staff. Assures coverage of Service Operations Department call center during normal operating hours. Documents calls and issues in C3PO application. Coordinates / advocates resolution of Member and Provider issues and concerns. Provides support to all the Contact Center Units in order to make members and provider inbound/outbound calls to educate, and bring issue resolution. Process Member and Provider requests accordingly of Departamental policies. Accomplish established metrics by the Contact Center Management on a daily, weekly and monthly basis. Forwards performs and/or processes orientations regarding disenrollment, cancellations, reimbursements, outbound calls, Member/Provider satisfaction surveys, etc. Maintain themselves in continuously learning environment with update information arriving through trainings, emails, one on one’s, staff meeting and any other way. Manage CTI system in a daily basis. 12.Report any unusual situation identified at the time of the member or provider contact.13.Notify supervisor of any processes not in compliance with the Plan’s SNP policies and MOC requirements. Manage and identify CMS Audit calls. Manage contacts requesting Interpreter Services. All staff will adhere to all operational policies and procedures related to the SNP product. Staff will attend to trainings per MOC guidelines related to functions of enrollment, customer service, provider relations/contracting or credentialing as applies. Special projects as assigned. EDUCATION AND EXPERIENCE Associate degree in health or business related field. Minimum one year of experience in a healthcare or Call Center environment. Prefered someone with health plan, medical billing or customer service experience. Evidence of good communication, interpersonal and problem‑solving skills. GENERAL ABILITIES AND KNOWLEDGE + Computer literate, preferably in the following applications: Word, Excel and Outlook. + Ability to respond to a high volume of work and maintain a polite and professional manner at all times. + Able to function with frequent interruptions. + Ability to prioritize workloads for maximum efficiency. + Able to sit for extended periods of time without compromising work performance. + Customer Service Skills: practicing, valuing and supporting service to both internal and external customers + Time Management Skills: establishing priorities and accomplishing tasks in a timely manner + Team Work: ability to work in a team environment to create solutions to problems + Fully Billingual (English and Spanish), preferable. GENERAL SKILLS + Have strong interpersonal skills. + Excellent verbal and written communication skills. + English literate. + Typing Skills + Multiple Task: Ability to write and maintain in the call focuses at the same time LANGUAGE SKILLS Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers. MATHEMATICAL SKILLS Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. REASONING ABILITY Ability to apply common sense understanding to carry out instructions furnished in written or oral form, detailed but not complicated. Ability to deal with problems involving few concrete variables in standardized situations. PHYSICAL AND MENTAL DEMANDS Position requires sitting and standing associated with a normal call center environment. Regularly talks and hears. This position requires that weight be lifted or force be exerted up to 10 pounds. ENVIRONMENTAL AND WORKING CONDITIONS Working on normal call center environment is required. The noise is typically moderate. Evening or weekend work, as necessary. Working flexible work hours; depending operational needs. This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve. If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!