Customer Services Specialist

Integrated Resources, Inc

HOWEL, MI

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JOB DETAILS

SKILLS

Billing, Business Writing, Call Centers, Compensation and Benefits, Computer Skills, Corporate Policies, Customer Experience, Customer Relations, Customer Support/Service, Customer Training, Documentation, HIPAA (Health Insurance Portability and Accountability Act), Health Maintenance Organization (HMO), Health Plan, Interpersonal Skills, Maintain Compliance, Microsoft Product Family, Multitasking, Point of Sale (POS) Systems, Preferred Provider Organization (PPO), Presentation/Verbal Skills, Problem Solving Skills, Process Improvement, Project/Program Management, Regulations, Resolve Customer Issues, Root Cause Analysis, Time Management, Training/Teaching, Trend Analysis, Writing Skills

LOCATION

HOWEL, MI

POSTED

1 day ago

['CUSTOMER SERVICE', 'CALL CENTER OPERATIONS', 'INTEGRITY', 'PATIENCE', 'EMPATHY', 'TACT', 'DIPLOMACY', 'PROBLEM SOLVING']

['BUSINESS WRITING', 'PC PROFICIENCY', 'MICROSOFT PROGRAMS', 'HMO DELIVERY SYSTEM', 'PPO DELIVERY SYSTEM', 'FLEXIBILITY', 'JUDGMENT', 'SERVICE EXCELLENCE', 'PROJECT MANAGEMENT', 'MULTITASKING', 'INTERPERSONAL SKILLS', 'LISTENING', 'VERBAL COMMUNICATION', 'POS DELIVERY SYSTEM', 'CLAIMS BILLING']Duties:
Job Summary:
This position has the following primary objectives with respect to customer relations for all HAP product lines: (1) Provide follow-up and courteous and prompt resolution to member inquiries by conducting thorough investigations and fully educating members and customers; (2) Support corporate and departmental goals, member enrollment activities and product implementations; (3) Research, investigate and resolve service failures. Improve the customer experience by identifying root causes, trends and recommend resolutions for service recovery and retention; (4) Educate members and prospective members to promote HAP as the health care coverage of choice.

Duties and Responsibilities:
-Respond to inquiries by telephone, mail and in person; research and answer inquiries, complaints and appeals by following all department standards, policies and procedures; direct inquiries to supporting departments for appropriate action and resolution.
-Educate existing and potential members on policies, procedures, product offerings, benefit plan and coverage provisions related to all HAP products.
-Document all incoming inquiries accurately in to track member inquiry history and trends.
-Practice and maintain confidentiality to Privacy and HIPAA regulations.
-Proactively seek training and development to enhance skills and abilities.
-Monitor workflow inbox and outstanding cases to ensure that all inquiries receive an appropriate response in a timely manner; contact members (by phone/or in writing), as needed, to ensure timely resolution and follow-up to inquiry.
-Interact with support departments in a professional manner to ensure member needs are met.
-Develop and maintain strong business relationships with inter-departments; continue to self-educate on changes in policies and procedures that occur in other departments which could have an impact on department operations and the servicing of member/customers.
-Attend training and development sessions or continuing education opportunities offered by Customer Service and maintain enhanced skill levels and performance.
-Interact with providers and their staff to obtain information for resolving customer inquiries and complaints.
-Ensure and maintain compliance of all department and corporate standards, policies and procedures.
-Recommend process improvements based on observations and trends identified while interacting with internal and external customers.
-Coordinate and assist with various departmental projects, member enrollment periods, outreach activities and corporate initiatives.
-Perform other related duties as assigned. null

Skills:
Required Skills & Experience:
-Minimum of two (2) years of recent Customer Service or Call Center experience within the last three years.
-Must be dependable.
-Demonstrate a high degree of integrity, patience, maturity, empathy, tact and Diplomacy.
-Demonstrate problem solving skills, flexibility, good judgment and ability to provide service excellence.
-Demonstrate the ability to handle assigned projects from start to successful completion including appropriate follow-up and documentation.
-Demonstrate the ability to handle multiple priorities concurrently in a timely and accurate manner.
-Demonstrate strong interpersonal, listening, verbal communication and business writing skills.
-Demonstrate efficiency in using a PC and various Microsoft programs.
-Fundamental understanding of HMO/PPO/POS delivery system and claims billing.
-Must be able to work flexible shifts, overtime including evenings and weekends as requested and/or scheduled.

Preferred Skills & Experience:
-N/A null

Schedule Notes:
Duration: 13 weeks
Min Exp: 2 years of recent Customer Service Experience
Schedule: M-F 9:00-5:00
HOWELL FAMILY MEDICINE, 1225 LATSON ROAD, SUITE 260, HOWEL, MI.

About the Company

Integrated Resources, Inc

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