Summary:

Research, mentor and provide issue resolution, including escalated calls with a member-centric sense of urgency. Identify, recommend, and implement process improvement opportunities to elevate the member experience and create call center efficiencies; support a variety of production non-phone tasks, correspondence and complex research while working closely with the training team to present training opportunities based on data and trending. Actively participate as a Subject Matter Expert (SME) on cross-functional projects from initial development to implementation; create and promote a culture that inspires others towards teamwork and collaboration as well as customer advocacy.

Responsibilities:

Resolve provider and member issues: provide constant feedback and recommend solutions/resolutions. Serve as customer advocate by providing assistance to resolve callers’ issues and problems; ensure proper issue closure and documentation. Serve as primary resource to respond and handle in-person customer support. Non-call tasks: Analyze and work production baskets to ensure timely resolution. Provide high quality, timely and accurate responses to customer correspondence and report requests. Leadership and support: mentor and coach Customer Service Associates. Serve as backup for/extension of leadership team empowered to handle emotional, escalated calls. Process improvement: identify, research and exploit cross-functional process improvement opportunities. Track and trend issues to determine if education or policy and procedural updates need to be made. Serve as primary source of expertise for projects and initiatives. Provide technical, administrative, and experiential support as needed on tasks/projects. Accountable for being an ambassador of the call center vision and mission, and inspire others towards teamwork, customer advocacy, and positive culture. Perform other related projects and duties as directed or required.

Qualifications: 

Bachelor’s Degree - additional experience/specialized training may be considered in lieu of educational requirements required 2 – 3+ years of relevant, professional work experience required Knowledge of medical terminology/coding; provider reimbursement; coordination of benefits; and medical claims required Ability to successfully manage multiple tasks simultaneously, with varying priority levels and deadlines required Ability to handle high volume of calls efficiently and courteously required Excellent customer service skills (telephonic, electronic, and in-person) required Excellent communication skills (verbal, written, interpersonal) with all types/levels of audience required Attention to detail; problem identification and resolution skills required Ability to perform basic to moderate analysis of information and data preferred Ability to perform in office environment with extended periods of sitting, using telephone, and viewing computer screens, standing, and reaching, lifting, filing required Additional Information Requisition ID: 2405D Hiring Range: $45,000-$77,000