Skills Required:
• 3+ years in a large call center with excellent customer service skills • Bilingual in Spanish/English is a major plus • Some experience in a call center or customer service role within the health insurance industry required.
Job Summary: Provide excellent service to customers through the resolution of basic customer inquiries received by phone or though written correspondence.
Responsibilities:
• Receive customer inquiries via phone, fax, mail, e-mail, etc. If necessary, probe for additional helpful information (i.e. member ID, claim number, name, etc.) in order to effectively handle inquiry.
• Review computer systems and/or other reference materials to complete verification process.
• Initiate investigation process based on the nature of the inquiry (claim, member information, benefits, enrollment, appeals, etc.).
• Utilize available resources to quickly and efficiently resolve or redirect inquiries in accordance with prescribed departmental process.
• Accurately document customer inquiries and actions taken in accordance with departmental quality guidelines to ensure appropriate follow up.
• Follow up on unresolved issues in a timely manner, escalating call trends to management.
• Deliver an excellent customer service experience while meeting quality and production standards.
• Perform other relevant tasks as assigned by management. Core Individual Contributor Competencies: Personal and professional attributes critical to successful performance for Individual
Contributors: • Customer Focus • Accountable • Learn • Communicate