Note: The job is a remote job and is open to candidates in USA. AmeriHealth Caritas is a healthcare solutions organization focused on helping people access care, stay well, and build healthy communities. The Customer Service Representative supports members, providers, and other customers through inbound and outbound communications regarding benefits, eligibility, and customer issues. The role provides member education, assists with care selection, documents inquiries, resolves concerns, and supports continuous process improvement.
Responsibilities
- Provide member education and assists members with Primary Care Physician (PCP) selection and assignments
- Assist with access to care and wellness programs
- Demonstrate passion for providing superior customer service to our members and continually seek to understand the needs of those we serve
- Follow internal processes and procedures to ensure all activities are performed in accordance with departmental and company policies and procedures
- Create accurate and timely documentation concerning all inquiries taken in accordance with established protocols to ensure resolution is provided and presented in a clear and accurate manner
- Present and project a positive image of the company in and out of the office to fellow associates, members, providers and the community by being courteous, helpful, energetic, respectful and polite
- Strive to resolve an inquiry on first contact while ensuring that the inquiries have been addressed to the customer’s satisfaction by using all resources in an efficient and timely manner
- Provide feedback and/or solutions to supervisor to ensure continuous process improvement and provide better customer experience
- Create and support an environment which fosters teamwork, cooperation, respect and diversity
- Maintain an awareness of all product knowledge information
- Able to respond positively to support change within the department and the company
- Routinely meet or exceed contact center key performance indicators
- Perform other duties as assigned
Skills
- * High School Diploma or GED
- * 1-year of prior customer service experience
- * Experience in the healthcare or managed care industry is preferred but required
- * Proficiency in PC applications within a Microsoft Windows environment
- * Demonstrated verbal and written communication skills combined with listening and problem-solving ability to identify needs, seek solutions and resolve customers' concerns
- * Ability to work well in a team environment and willingness to learn and adopt customer service methods and practices
- * Training is conducted **onsite Monday through Friday from 8:30 AM – 5:00 PM** and lasts approximately **6–7 weeks (maximum)**. During this period, you are required to be **fully available and onsite for the entire duration of training**
- * Upon successful completion of training, the role will transition to a **remote work environment**. However, you may be required to report to a business office for **mandatory meetings and/or technical support related to remote work**
- * Our Contact Center operates **24 hours a day**, and this position requires flexibility to work shifts between **7:00 AM – 7:00 PM**. Start times will vary, typically ranging from **7:00 AM to 10:30 AM**, and are assigned based on business needs (example shift: **10:30 AM – 7:00 PM**)
- * Your **permanent schedule will be assigned toward the end of training** and will remain consistent based on operational needs
Benefits
- Flexible work solutions, including remote options and hybrid work schedules
- Paid time off
- Paid holidays
- Volunteer events
- Health insurance coverage for you and your dependents starting Day 1
- 401(k) retirement savings plan
- Tuition reimbursement
- Remote work environment upon successful completion of training, with mandatory business office visits potentially required for meetings and/or technical support related to remote work
Company Overview
Company H1B Sponsorship