WORK FROM HOME - Customer Service Call Center Representative
Essential Duties and Responsibilities (include but are not limited to):
- Be available to handle member inquiries.
- Represent Health Plan by answering and documenting all incoming contacts to determine their nature, and respond to complex calls related to specialized product lines or ques.
- Respond with empathy to complaints and concerns from members concerning health plan benefits, account status, payment history, and medical services.
- Initiate contact with the appropriate health plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed.
- Evaluate data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery.
- Document according to procedure.
- Assist department in reaching call handling goals, first contact resolution goals, complaint resolution compliance, member retention and making return contact as warranted.
- Complete required training (including, but not limited to, annual certifications) and understand how to use tools available to recall necessary information.
- Effectively diffuse anger, tension, and hostility, within regulatory guidelines.
- Maintain awareness of the way performance and actions affect members.
- Be open and receptive to feedback and change behavior to improve performance.
- Be able to answer Healthcare Member and Provider inquiries and type information into the computer system simultaneously.
Qualifications - External
- Must have Internet to include a router with Ethernet jack for connectivity to PC (Subject to change: FS Guidelines 25down/15 up min; BCBSM Guidelines 50 down/25 up min)
- Must have a private workstation to perform your work
- Must have quiet area free from distractions
- Must have childcare/Family care, as you are unable to perform job and take care of child/children or family members
- Call center experience preferred.
- Health insurance experience
- High School diploma or equivalent is required.
- 2 years customer service experience preferred
- Minimum typing speed = 30-35 wpm preferred
- Substantial understanding of the job, apply knowledge and skills to complete a wide range of tasks.
- Excellent written and verbal skills.
- Problem-solving skills.
- Basic knowledge of personal computers required
- Strong reading comprehension and writing skills
- Follow established procedures to meet customer needs.