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 Review Member Advance: Eligibility Inquiry, Benefit Inquiry, General, Complaint, Correspondence Inquiry, Add/Remove Dependent, Service Review, New Member Exp, Internal Regional Request, IVR Defaults Medicare (For up to two (2) regions) Premium Billing Enterprise: Billing Inquiry, Make Payment, Complaint, EFT Inquiry, General, Reinstatement Request, Service Review Billing, 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 queues Responds professionally to inquiries from internal/external customers Promotes, 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 service Initiates contact with the appropriate Health Plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed. Documents conversations with members according to procedure Follows established procedures to meet customer/member needs Required to effectively interact with diverse work units and relevant organizational departments Has substantial understanding of the assigned skills and applies knowledge and skills to complete a wide range of tasks Ability to understand relevant policies, processes and customers Assist the department in meeting customer needs and reaching department expectations Completes required training and understand how to use tools available to recall necessary information#KS1 **Only those lawfully authorized to work in the designated country associated with the position will be considered.**