Customer Service Representative

Job Description:

Under the direct supervision of Operation Supervisors, the Customer Service Representative is responsible for supporting a diverse membership community and their providers as well as other customers in a timely manner. This includes inbound and outbound engagement with members and/or providers via phone calls or correspondence regarding benefits, eligibility, or customer issues.

Responsibilities:

• Conducting Welcome Calls to new members and performing Health Assessment Surveys as needed. 

• Providing member education and assists members with Primary Care Physician (PCP) selection and assignments. 

• Assists with access to care and wellness programs.

• Demonstrates passion for providing superior customer service to our customers and continually seeks to understand the needs of those we serve.
• Follows internal processes and procedures to ensure all activities are performed in accordance with departmental and company policies and procedures.
• Create accurate and timely documentation concerning all inquiries taken in accordance with established protocols to ensure resolution is provided and presented in a clear and accurate manner.
• Present and project a positive image of the company in and out of the office to fellow associates, members, providers and the community by being courteous, helpful, energetic, respectful and polite.
• Strive to resolve an inquiry on first contact while ensuring that the inquiries have been addressed to the customer’s satisfaction by using all resources in an efficient and timely manner.
• Provide feedback and/or solutions to supervisor to ensure continuous process improvement and provide better customer experience.
• Creates and supports an environment which fosters teamwork, cooperation, respect and diversity.
• Maintain an awareness of all product knowledge information.
• Able to respond positively to support change within the department and the company.
• Routinely meet or exceed contact center key performance indicators.

• Perform other duties as assigned.

   

Scheduling / Shift: This full-time role operates within our core operational hours of 8 AM to 8 PM, Monday through Sunday. The ideal candidate will be flexible to work various shifts within this timeframe, including weekends. Shift start times: 8:30AM, 9:30AM, or 11:30AM.

Education & Experience requirements:

• High School Diploma or GED.
• 1-year of prior customer service experience.
• Experience in the healthcare or managed care industry is preferred but required.
• Proficiency in PC applications within a Microsoft Windows environment.
• Demonstrated verbal and written communication skills combined with listening and problem-solving ability to identify needs, seek solutions and resolve customers’ concerns.

• Ability to work well in a team environment and willingness to learn and adopt customer service methods and practices.

   

Our Comprehensive Benefits Package

Flexible work solutions including hybrid work schedules. Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k), Tuition reimbursement, and more.

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation’s leaders in health care solutions, we offer our associates the opportunity to impact on the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to hear from you.

Headquarters in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.