What are the responsibilities and job description for the Customer Service Representative II position at The Alliance?
How You Will Contribute
Customer Support & Advocacy
Issue Resolution & Collaboration
Customer Insights & Continuous Improvement
Customer Support & Advocacy
- Maintains a positive and approachable demeanor in all customer interactions, showing a genuine interest in helping consumers and improving their experience.
- Helps member employees navigate their health insurance network providers.
- Independently provides customer service via telephone and email, answering questions and resolving issues related to electronic claims filing, repricing, network-related inquiries, and other established Customer Services processes.
- Refers consumers to the appropriate third-party administrator (TPA) or other resource for claims status, eligibility, or matters requiring assistance outside The Alliance’s scope.
- Provides education and resources to empower consumers to make informed health care decisions.
- Responds to written correspondence within established timeframes.
Issue Resolution & Collaboration
- Researches customer questions and concerns using available systems and resources and identifies appropriate solutions or next steps.
- Independently resolves standard customer issues and determines when additional expertise, referral, or escalation is appropriate.
- Takes ownership of customer inquiries and supports timely follow-through and resolution.
- Accurately documents customer interactions, research, actions taken, and relevant information to support continuity of service.
- Collaborates with Customer Services staff, other departments, and appropriate external partners to resolve customer issues.
Customer Insights & Continuous Improvement
- Proactively collects and shares consumer feedback to identify recurring concerns and opportunities to improve the customer experience.
- Recognizes patterns in customer inquiries and communicates observations to the Director or other appropriate Alliance staff.
- Contributes ideas and feedback that support improvements to Customer Services processes, resources, and service delivery.
- Maintains proficient knowledge of The Alliance’s networks, services, systems, terminology, and Customer Services processes.
- Assists with data entry and other departmental responsibilities as needed.
Salary : $21 - $23