The role of Customer Service Representative (Level 2) is primarily responsible for providing attentive customer services to providers. The representative will provide timely and accurate responses in a professional and courteous manner utilizing defined processes and guidelines. Responsibilities include answering routine inquiries, resolving issues, and delivering exceptional customer experiences.

Essential Functions:

Using top-notch interpersonal skills, being able to understand customers inquiries or complaints and deal effectively with callers who may be frustrated or angry.
Handling inbound calls/outbound calls, voicemails, and emails from providers regarding a variety of requests related to benefits, eligibility, network/authorizations, claims inquiry, claims escalations and reconsiderations / appeals.
Demonstrating and maintaining professional oral and written communication with customers, co-workers and other stakeholders.
Navigating multiple databases simultaneously to research and create resolutions for providers.
Possess a professional and friendly attitude and be able to quickly develop a rapport with customers over the phone.
Using excellent listening skills with the ability to ask probing questions, understand concerns, and overcome objections.
Identifying, researching, and resolving customer issues using different databases.
Follow-up on customer inquiries not immediately resolved.
Consistently meeting established performance and quality standards.
Participate in recommended or required continuing education seminars and training sessions as needed.

Additional Functions:

Collaborate with other areas regarding call center related functions, inquiries, or issues.
Participate in special projects as requested.
Communicates clearly and concisely, with sensitivity to the needs of others.
Maintains the confidentiality of all company procedures, results, and information about participants, providers, and employees.
Maintains courteous, helpful, and professional behavior on the job.
Establish and maintain effective working relationships with co-workers.
Follows all Policies and Procedures and HIPAA regulations.
Maintains a safe working environment.
All other duties as assigned.

Knowledge, Skills, and Abilities:

Graduation equivalent degree required.
Customer service experience in a call center environment of 18 to 24 months with a Healthcare focus - Medicare/Pace/Claims knowledge preferred.
Familiarity with cloud-based contact center software is desirable.
Strong organizational, written, and verbal communication skills.
Ability to organize and follow-up on multiple tasks/details with accuracy and timeliness.
Strong personal computer usage and internet proficiency skills. Having Microsoft Excel knowledge is an added advantage.
Strong work ethic and self-starter, able to effectively manage multiple priorities and adapt to change within a fast-paced call center environment.
Ability to learn and navigate new software quickly.
Flexible scheduling as business needs dictate.

Physical Demands & Requirements:

Communicate by way of the telephone with participants, customers, vendors and staff.
Operate a computer and other office productivity machinery.
Remain stationary for extended periods of time.
Occasionally exert up to 10 kilograms of force to lift, carry, push, pull or move objects.
Visual acuity to perform activities such as identifying, inputting and analyzing data on a computer terminal and/or in hard copy.

Work Environment:

This job is operated in a professional office environment with a conversational noise level.
No substantial exposure to adverse environmental conditions is expected.
Moderate pressure to meet scheduled appointments and deadlines.

Benefits:

Group Medical Insurance
Office Transport

Shift Timings: US Shift 8AM to 5PM (EST, CST, MST, PST). Based on business requirements.

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