Customer Service Representatives make a difference in the lives of our members each day as they look to you as their trusted advisor and advocate. You’ll be empowered to compassionately deliver an exceptional experience to between 50 to 70 callers per day – always remembering that there is a real person on the other end of the phone who is looking for help, guidance, and support. You’ll help them make informed decisions about their services by answering their questions, or resolving their issues. You’ll do this by developing and maintaining a productive relationship and interaction with all callers, while providing personalized, and consultative education and information. These positions are full-time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of (6am – 8pm). Est. 

Primary Responsibilities:

• Respond to and resolve on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence
• Help guide and educate customers about the fundamentals and benefits of consumer-driven health care topics to include managing their health and well-being by selecting the best benefit plan options, maximizing the value of their health plan benefits and choosing a quality care provider
• Intervene with care providers (doctor’s offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed
• Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
• Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
• Provide education and status on previously submitted pre-authorizations or pre-determination requests
• Meet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, first call resolution and attendance
• Prefer 1 year prior experience in an office setting,  call center setting or phone support role, but not required

• Previous experience working at home/telecommuting is preferred, but not required
• An education level of at least a high school diploma or GED OR 10 years of equivalent working experience
• Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills and learning new computer programs
• Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner, consistently meeting commitments)
• Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member 
• Proficient problem solving approach to quickly assess current state and formulate recommendations
• Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon
• Flexibility to customize approach to meet all types of member communication styles and personalities
• Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrating personal resilience
• Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed
• All new hires will be required to successfully complete the online Customer Service training classes and demonstrate proficiency of the material

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas
• Required to have a work area in a section of the residence that provides information privacy
• Required to keep all Company sensitive documents secure
• Required to have lockable drawers for the securing of confidential information