Job Summary :

Under the direct supervision of the Customer Support Center Manager, the Customer Support Representative I (CSR) is the front line support to members, member advocates and providers.

The CSR I provides superior customer service to all incoming callers while assisting with their inquiries and requests. Calls include but are not limited to eligibility verification, authorizations status, PCP changes, appeals and grievances.

CSRs are expected resolve and / or escalate inquiries / requests and document each call interaction in a clear, concise, professional and timely manner.

Pay Rate : $23.00 / hr

Responsibilities :

• Provide superior customer service to all incoming callers to ensure an exceptional customer experience.
• Receive and respond to incoming calls from members, member advocates, providers, health plan representatives, etc. Identify and resolve issues related to patient care and services.
• Provide assistance with inquiries such as eligibility, authorizations status, PCP changes, appeals and grievance intake, and various other inquiries.
• Make outbound calls for follow up purposes when needed. Set reasonable follow up expectations with callers and meet or exceed those commitments.
• Continuously work on open inquiry log and maintain minimal open cases.
• Adhere to individual and departmental key performance indicators (KPIs) such as number of inbound calls per day, wrap up time, handle time, QA audit performance,
• Perform other duties as assigned.

Requirements :

• High School Diploma or GED required.
• Associates or bachelor’s degree preferred.
• Minimum of 2 years of ACD call center experience required.
• Minimum of 1 year in medical or healthcare environment preferred.
• Bilingual in Spanish required.

Skills

• Ability to communicate professionally, diplomatically, clearly and concisely, both verbally and in writing with others.
• Ability to answer a high volume of calls in a fast pace call center environment.
• Strong problem identification and resolution skills.
• Proficient with computer software including Microsoft Office applications (Outlook, Excel and Word).
• Ability to multi-task, set priorities and pay attention to details.
• Ability to successfully interact with members, medical professionals, health plan and government representatives.
• Ability to type a minimum of 35-40 words per minute.

Last updated : 2024-04-29