eService Call Center Asscociate

Skills Required:

• 3+ years in a large call center with excellent customer service skills • Bilingual in Spanish/English is a major plus • Some experience in a call center or customer service role within the health insurance industry required.

Job Summary: Provide excellent service to customers through the resolution of basic customer inquiries received by phone or though written correspondence.

Responsibilities:

• Receive customer inquiries via phone, fax, mail, e-mail, etc. If necessary, probe for additional helpful information (i.e. member ID, claim number, name, etc.) in order to effectively handle inquiry.

• Review computer systems and/or other reference materials to complete verification process.

• Initiate investigation process based on the nature of the inquiry (claim, member information, benefits, enrollment, appeals, etc.).

• Utilize available resources to quickly and efficiently resolve or redirect inquiries in accordance with prescribed departmental process.

• Accurately document customer inquiries and actions taken in accordance with departmental quality guidelines to ensure appropriate follow up.

• Follow up on unresolved issues in a timely manner, escalating call trends to management.

• Deliver an excellent customer service experience while meeting quality and production standards.

• Perform other relevant tasks as assigned by management. Core Individual Contributor Competencies: Personal and professional attributes critical to successful performance for Individual

Contributors: • Customer Focus • Accountable • Learn • Communicate

Qualifications:

Education/Experience:

• High school degree or equivalent required. Some college preferred.

• Some experience in a call center or customer service role within the health insurance industry required.

Knowledge:

• Medical terminology and medical billing coding preferred Skills and Abilities: • Excellent Customer Service skills including the ability to manage and diffuse irate calls • Ability to work in a high pressure, fast pace environment • Keyboarding proficiency • PC proficiency • Strong verbal and written communication • Interpersonal skills (i.e. active listening) • Investigative and analytical skills • Ability to multitask • Time management skills • Flexibility and adaptability • Ability to work effectively within a team environment