Billing, Call Centers, Customer Relations, Customer Retention/Renewal, Customer Satisfaction, Customer Support/Service, Documentation, Health Plan, Performance Management, Philosophy, Resolve Customer Issues, Team Player, Telephone Skills, Time Management, Voice Response Systems
LOCATION
Duluth, Georgia
POSTED
2 days ago
Customer Services RepresentativeThe Customer Services Representative is responsible for the increase in customer satisfaction and retention by providing members, customers, patients, and providers with accurate, consistent, timely, and meaningful information. They will provide higher level support to members' inquiries and issues as they utilize the Client's Plan and provider services, continuing to build rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines.Major Responsibilities/Essential Functions:Available to handle member inquiries regarding: Member Core: Facility Inquiry, Web Support, Promote Client, Order ID Card, Complaint, ID Card Inquiry, Service ReviewMember Advance: Eligibility Inquiry, Benefit Inquiry, General, Complaint, Correspondence Inquiry, Add/Remove Dependent, Service Review, New Member Exp, Internal Regional Request, IVR DefaultsMedicare (For up to two (2) regions)Premium Billing Enterprise: Billing Inquiry, Make Payment, Complaint, EFT Inquiry, General, Reinstatement Request, Service ReviewBilling, 1095 Tax Form, SLP* (escalations to Tier 3)Represents Health Plan by answering and documenting all incoming contacts to determine their nature and to respond to complex calls related to specialized product lines or queuesResponds professionally to inquiries from internal/external customersPromotes, ensures and provides customer service to internal/external customers by demonstrating skills which are consistent with the organization's philosophy of providing extraordinary customer relations and quality serviceInitiates contact with the appropriate Health Plan, medical group, and facility personnel to obtain information relevant to the concern or inquiry as needed. Evaluates data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recoveryDevelop a full awareness of the way performance and actions affect members and Member Service. Contact Centers's (MSCC) performance guarantees (call handling, first call resolution, complaint resolution compliance, member retention, and return contact as warranted)Consistently supports compliance and the Principles of Responsibility (Client Code of Conduct) by maintains the privacy and confidentiality of information and protects the assets of the organizationPerforms other relevant duties as required. Documents conversations with members according to procedureFollows established procedures to meet customer/member needsRequired to effectively interact with diverse work units and relevant organizational departmentsHas substantial understanding of the assigned skills and applies knowledge and skills to complete a wide range of tasksAbility to understand relevant policies, processes, and customersAssist the department in meeting customer needs and reaching department expectationsCompletes required training and understand how to use tools available to recall necessary information
About the Company
R
Rose International
Founded in 1993 by Sue Bhatia, Rose International is one of the nation's leading minority- and woman-owned providers of Staffing and Total Talent Solutions. We serve companies in all 50 states and employ thousands of people across the country.