Customer Service Representative

Job Description

• Answer incoming phone calls from customers (i.e. members, providers, facilities) in a call center setting and identify the type of assistance needed (i.e. benefit and eligibility, billing and payments, authorizations for treatment, explanation of benefits, and claims information).
• Focus on resolving issues on the first call, navigating through complex computer systems to identify the status of the issue and provide appropriate response to caller.
• Deliver information and answer questions in a positive manner to facilitate strong relationships with members and providers.
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems.
• Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues.
• Meet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, and attendance.
• Demonstrated ability to listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner.
• Strong communication skills, empathy.
• Critical thinking skills to problem solve and resolve customer concerns.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

• High School Diploma / GED (or higher) OR equivalent work experience.
• Familiarity with computer and Windows personal computer applications, which includes the ability to navigate and learn new and complex computer system applications.
• Ability to work any 8-hour shift schedule (shifts will be assigned) between the hours of 6:00 AM - 10:00 PM CST (Central Standard Time zone) including the flexibility to work occasional overtime based on business need.

• 1+ years of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.), using phones and computers as the primary job tools.
• Prior health care experience.