Associate

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

*Web camera visibility

Qualifications - External

• Must have Internet to include a router with Ethernet jack for connectivity toPC (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.