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.
