Job Description

Summary

The role of Customer Service Representative (Level 2) is primarily responsible for providing attentive customer services to providers. The representative will provide timely and accurate responses in a professional and courteous manner utilizing defined processes and guidelines. Responsibilities include answering routine inquiries, resolving issues, and delivering exceptional customer experiences.

Essential Functions:

• Using top-notch interpersonal skills, being able to understand customers’ inquiries or complaints and deal effectively with callers who may be frustrated or angry.
• Handling inbound calls/outbound calls, voicemails, and emails from providers regarding a variety of requests related to benefits, eligibility, network/authorizations, claims inquiry, claims escalations and reconsiderations / appeals.
• Demonstrating and maintaining professional oral and written communication with customers, co-workers and other stakeholders.
• Navigating multiple databases simultaneously to research and create resolutions for providers.
• Possess a professional and friendly attitude and be able to quickly develop a rapport with customers over the phone.
• Using excellent listening skills with the ability to ask probing questions, understand concerns, and overcome objections.
• Identifying, researching, and resolving customer issues using different databases.
• Follow-up on customer inquiries not immediately resolved.
• Consistently meeting established performance and quality standards.
• Participate in recommended or required continuing education seminars and training sessions as needed.

Additional Functions:

• Collaborate with other areas regarding call center related functions, inquiries, or issues.
• Participate in special projects as requested.
• Communicates clearly and concisely, with sensitivity to the needs of others.
• Maintains the confidentiality of all company procedures, results, and information about participants, providers, and employees.
• Maintains courteous, helpful, and professional behavior on the job.
• Establish and maintain effective working relationships with co-workers.
• Follows all Policies and Procedures and HIPAA regulations.
• Maintains a safe working environment.
• All other duties as assigned.

Knowledge, Skills, and Abilities:

• Graduation equivalent degree required.
• Customer service experience in a call center environment of 18 to 24 months – with a Healthcare focus – Medicare/Pace/Claims knowledge preferred.
• Familiarity with cloud-based contact center software is desirable.
• Strong organizational, written, and verbal communication skills.
• Ability to organize and follow-up on multiple tasks/details with accuracy and timeliness.
• Strong personal computer usage and internet proficiency skills. Having Microsoft Excel knowledge is an added advantage.
• Strong work ethic and self-starter, able to effectively manage multiple priorities and adapt to change within a fast-paced call center environment.
• Ability to learn and navigate new software quickly.
• Flexible scheduling as business needs dictate.

Physical Demands & Requirements:

• Communicate by way of the telephone with participants, customers, vendors and staff.
• Operate a computer and other office productivity machinery.
• Remain stationary for extended periods of time.
• Occasionally exert up to 10 kilograms of force to lift, carry, push, pull or move objects.
• Visual acuity to perform activities such as identifying, inputting and analyzing data on a computer terminal and/or in hard copy.

Work Environment:

• This job is operated in a professional office environment with a conversational noise level.
• No substantial exposure to adverse environmental conditions is expected.
• Moderate pressure to meet scheduled appointments and deadlines.

Benefits:

• Group Medical Insurance
• Office Transport

Shift Timings: US Shift – 8AM to 5PM (EST, CST, MST, PST). Based on business requirements.