Participant Support Specialist

Scope/Impact

The Participant Support Specialist role is key to our success as an organization. Under direct supervision, and utilizing the training received, the Participant Support Specialist’s function is to provide effective and accurate responses to our callers, using in-depth knowledge of the customer’s plan(s) and program(s) as well as communicating effectively with internal team members throughout the department and organization. Strong proactive problem-solving and troubleshooting skills are key components of this role.

Effective performance of all duties and responsibilities of the position will assure accurate and timely completion of required tasks and compliance with required timelines.

Essential Functions

• Receive incoming calls from participants and providers answering questions and solving problems efficiently and accurately to exceed customer’s service expectation. 
• Receive incoming chats, always using excellent spelling and grammar.
• Follow up with participants or administrators to resolve any open issues.
• Be available on phones and/or chats at all times.
• Log all calls and chats in flex connect.
• Complete all documentation as needed, stop payments, ach reversals, CEC and claim adjustments.
• Log in and out of phone system when away from desk.
• Keeps the Department Manager fully informed on all problems or unusual matters of significance and escalates when necessary.
• Takes direction from the Participant Support Center managers, supervisors, and trainers and any/all company managers and supervisors.

Other Function(s)

• Champion P&A Group values and policies.
• Maintain data protection, privacy, security and maintain HIPAA compliance for participants and clients.
• Completes any additional assignments as requested by the executive/management team members
• Performs all duties and responsibilities in a timely and effective manner in accordance with established departmental procedures

Minimum Requirements

EDUCATION / EXPERIENCE

• High School Diploma required.
• Associate’s Degree and/or Equivalent Work Experience preferred
• 1-3 years of experience in a customer service setting.

SKILLS/KNOWLEDGE/COMPETENCIES

• Solid oral and written communication skills with ability to convey one’s message in appropriate manner (grammar, professionalism) with diplomacy and tact
• Excellent customer service and interpersonal relationship skills
• Basic knowledge and understanding of computers and various software. Knowledge and experience with Microsoft Word, Outlook, Teams, and One Note is a plus.
• Proven ability to effectively manage multiple priorities utilizing effective organizational and time management practices
• Strong initiative with demonstrated ability to work independently in an environment with critical deadlines
• Strong attention to detail
• Ability to recognize need for escalation to appropriate Administrator/Department Manager

TRAVEL

No travel is required for this role

Working Conditions

Fast paced work environment; flexibility to occasional work overtime as required due to changing business demands. The work environment is moderately sedentary and typical of general office conditions with regard to standing, sitting, walking; no adverse conditions.   An equal opportunity employer and a smoke, drug and alcohol-free workplace.

Other

Completes any additional assignments and projects as requested by management.  This job description is designed to cover a general list of responsibilities and expectations for this role and does not contain a complete listing of activities, duties or responsibilities that are required for the role. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time with or without advance notice.

EOE