Medical Customer service representative Qualification
- For Medical Management Bachelor's degree in Nursing or any health science related field.
- For NA High School Equiv.
Support corporate performance and quality objectives in a high-volume Call Center.
Responsible for inbound phone inquiries primarily dealing with either:
· Member benefits and eligibility related to the HMO, EPO/PPO, Medicare and Medicaid, CHP and
· Resolve issues with respect to benefits and eligibility by researching documentation, system information or gaining knowledge from other employees, management or departments.
· Interact with customers, document call specifics and demonstrate quality program behaviors to create an outstanding relationship with each caller.
· Work with outside vendors as needed to answer questions or resolve issues.
· Respond to member correspondence/email in writing utilizing an existing system to effectively respond to members.
· Conduct orientation to new members by providing an overview of the Information and pertaining administrative policy.
· Demonstrate awareness, motivation, and technical skills to assist in the development and growth of the customer service teams and help to identify process improvements.
· Assist in department/company projects, as needed, i.e. Provide feedback about the customer's experience.
EDUCATION and EXPERIENCE
· Must have a minimum 1 year experience in a high-volume inbound Call Center environment with strong customer service skills. Health insurance experience is a must (Medicare/Medicaid).
· Must be computer literate and able to multi-task – i.e. document call experience while using the Quality Program.
· Typing 35/wpm required
· Excellent communication and interpersonal skills.
· Must be able to meet attendance, performance and adherence requirements in a high-volume inbound Call Center.
· Must be able to adhere to flexible work schedule.
· Customer Focus/Communication
· Dependability/Adaptability Must Have Skills
- Customer Service-Healthcare