Customer Service Representative GA, Duluth

Position: Customer Service Representative Jobs  GA, Duluth | Rose International Job
Assessments

Required:

Must pass CSR 1 Assessment to be considered

Required

Education:

High School Diploma or equivalent

Location Requirements:

Must be local to the Duluth, GA area

Schedule Requirements: (Member Service Contact Center (MSCC) operates Monday
- Friday 7:00AM - 9:00 PM and Saturday and Sunday 8:00AM to 7:00PM)

Must be flexible to work weekends and late shift

Must be flexible to work within the hours of operations which are:
Monday
- Friday 7:00AM - 9:00 PM EST

No time off during first 90 days (training)

Time off after and during holidays is discouraged

Required Experience, Knowledge &

Skills:

Candidate must have call center specific experience

Minimum two (2) years of customer service experience or member-interacting experience required (not retail)

Must pass knowledge checks while in training.

Preferred Experience , Knowledge &

Skills:

Health insurance industry experience within a call center

Soft

Skills Required:

Excellent written and verbal communication skills

Demonstrated analytical and problem-solving skills

Strong knowledge of systems used within the MSCC

Ability to read and respond briefly, clearly and effectively

Ability to think critically and problem solve

Manage own work with minimal direction

The Customer Services Representative is responsible for the increase in customer satisfaction and retention by providing members, customers, patients and providers with accurate, consistent, timely, and meaningful information. They will provide higher level support to members' inquiries and issues as they utilize the Client's Plan and provider services, continuing to build rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines.

Major Responsibilities/

Essential Functions:

Available to handle member inquiries regarding:
Member Core:
Facility Inquiry, Web Support, Promote Client, Order , Complaint,  Inquiry, Service Review

Member Advance:
Eligibility Inquiry, Benefit Inquiry, General, Complaint, Correspondence Inquiry, Add/Remove Dependent, Service Review, New Member Exp, Internal Regional Request, IVR Defaults

Medicare (For up to two (2) regions)

Premium Billing Enterprise:
Billing Inquiry, Make Payment, Complaint, EFT Inquiry, General, Reinstatement Request, Service Review

Billing, 1095 Tax Form, SLP* (escalations to Tier
3)

Represents Health Plan by answering and documenting all incoming contacts to determine their nature and to respond to complex calls related to specialized product lines or queues

Responds professionally to inquiries from internal/external customers

Promotes, ensures and provides customer service to internal/external customers by demonstrating skills which are consistent with the organization's philosophy of providing extraordinary customer relations and quality service

Initiates contact with the appropriate Health Plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed. Evaluates data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery

Develop a full awareness of the way performance and actions affect members and Member Service. Contact Centers's (MSCC) performance guarantees (call handling, first call resolution, complaint resolution compliance, member retention, and return contact as warranted)

Consistently supports compliance and the Principles of Responsibility (Client Code of Conduct) by maintains the privacy and confidentiality of information and protects the assets of the organization

Performs other relevant duties as required. Documents conversations with members according to procedure

Follows established procedures to meet customer/member needs

Required to effectively interact with diverse work units and relevant organizational departments

Has substantial understanding of the assigned skills and applies knowledge and skills to complete a wide range of tasks

Ability to understand relevant policies, processes and customers

Assist the department in meeting customer needs and reaching department expectations

Completes required training and understand how to use tools available to recall necessary information

#KS1

• ** Only those lawfully authorized to work in the designated country associated with the position will be considered.**

• ** Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.**

Benefits:

For information and details on employment benefits offered with this position, please visit

here
. Should you have any questions/concerns, please contact our HR Department via our secure
website

California Pay Equity:

For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website

here

Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation,…