Customer Service Representative

  

Customer Service Representative
Program Support (80%) Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity, and accountability. Maintains departmental productivity and quality standards. Follows through on and completes all member and provider inquiries or requests during the original member and provider interaction. Serves as a resource for other team members. Administrative Support (15%) Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department. Addresses member and provider inquiries, questions, and concerns in all areas including eligibility, enrollment, claims or authorization status, benefit interpretation, and referrals/authorizations for medical care in-person or telephonically. Enters accurate and complete documentation into internal application systems regarding all concerns and/or inquiries from the member and provider interaction. Communicates, builds, and maintains internal and external relationships by prompt and accurate service delivery. Identifies and communicates challenges that might arise with the use of professional judgment while adhering to departmental policies and procedures. Other Responsibilities (5%) Completes other projects and duties as assigned.

Duration: 06 Months (Contract). Start Date: ASAP. Interview Type: In-Person/Web Interview. Post-Training Schedule: Between 8:00 AM – 5:30 PM (8-hour shifts with 30 mins-1 hour lunch break). Schedule Flexibility: Actual post-training schedule provided towards the end of training. Schedule subject to change based on business needs (employees will be notified at least a day in advance). Employees scheduled to end at 5:30 PM must stay until the call queue clears, potentially extending their shift.