Customer Service Entry Level
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 queues.
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, of members expressing concerns about.
Maintain awareness of the way performance and actions affect members and the financial stewardship.
Be open and receptive to feedback, and change behavior to improve performance.
Working hours: 8 AM - 8 PM
2 or more years of experience
Healthcare experience a plus
To apply email : firstname.lastname@example.org
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