We are seeking a Customer Service Representative to join our team! You will be responsible for helping customers by providing product and service information and resolving technical issues. This position is responsible for assisting Members, Providers and
Clients with accurate, timely and responsive replies and resolutions regarding Client Health Plans claims, benefits, provider issues, and enrollment and billing inquires.
Handle customer inquiries and complaints
Provide information about the products and services
Troubleshoot and resolve product issues and concerns
Document and update customer records based on interactions
Develop and maintain a knowledge base of the evolving products and services
Interact with Provider Relations, Utilization Management and Client Services daily to make appropriate determinations based on the call received
Prepare appropriate documentation in company call tracking system on incoming telephone calls
100 % documentation of calls
95% overall quality which includes technical skills and telephone etiquette
70% availability time ( this means 70% of the day the CSR is available to handle incoming calls)
Handle 60 or more calls a day
30% or less calls placed on hold
Previous experience in customer service, sales, or other related fields
Ability to build rapport with clients
Ability to prioritize and multitask
Positive and professional demeanor
Excellent written and verbal communication skills
High School Diploma required
1-2 years previous customer service experience required, preferably in a managed Care/healthcare environment.
Experience working a call center a plus
Prior knowledge of managed care benefit plans, design and medical terminology and/or medical billing and coding a plus.