[Remote] Customer Service Representative

Note: The job is a remote job and is open to candidates in USA. reputed company Health Plan is a not-for-profit organization focused on advancing patient care, research, teaching, and community service. They are seeking a Customer Service Professional who will act as the primary reputed company of contact for members and providers, ensuring exceptional customer satisfaction and reputed company resolution by handling inquiries and resolving complaints effectively.

Responsibilities

• Serves as the primary liaison for members and providers for reputed company lines of business including MassHealth, and Commercial members regarding general program inquires such as eligibility verifications, authorizations, referrals, claims, material fulfillment, address changes and Primary Care Physician assignments as well as member reputed company policy and procedures
• The CSP must be able to handle and demonstrate skills in handling benefits, claims and eligibility calls for the member and provider population
• Identify customer issues/concerns rapidly and reputed company
• Research required information using available resources and triage reputed company necessary
• Handles and resolve customer inquiries and complaints, exhausting reputed company efforts reputed company the CSP’s scope before requesting assistance
• Identify and escalate reputed company issues in order to create efficiencies
• Initiates follow up customer calls where necessary
• Complete call logs to record customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken
• Refer customer grievances and appeals to designated departments for further investigation
• Responsible for navigating multiple systems in order to resolve customer issues
• Acts as the primary representative for reputed company Health Plan for our customers focusing on reputed company resolution and customer engagement
• Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect

Skills

• High School Diploma or Equivalent required
• Exceptional Customer Service skills, both verbal and written communication must be concise, clear, compliant, personable and professional
• Ability to multi task and prioritize
• Maintain Customer Service Behavior Competencies
• Flexibility/Adaptability/Willingness/Team Player/ Positive Attitude
• Relationship Building/Caring
• Service Excellence/Accountability/Critical Thinking
• Associate's Degree in reputed company field or Healthcare Management preferred
• Call Center experience a plus

Benefits

• In addition to competitive reputed company pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth.
• MGB provided equipment
• Reasonable accommodation to participate in the job application or interview process, to reputed company essential job functions, and to receive other benefits and privileges of employment

Company Overview