Customer Service Associate

Job Description

Job Description

The Customer Experience Coordinator provides outreach and support to ensure all our client's Medicare members have access to the care they deserve.

You will navigate their members through their health care and benefits, and connect the dots between their provider network, health plan operations, and supplemental vendors.

You will be alongside our members every step of the way to ensure they are never alone in their healthcare journey. This is a role for a passionate and experienced customer service representative who understands the meaningful contribution they make to our members' healthcare outcomes.

Essential Duties and Responsibilities :

Understand procedures, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries;

serve as a subject matter expert in the healthcare experience that our members navigate daily

Be a representative that provides outbound and inbound support via the phone at a fast pace.

Maintain case ownership of Tier 1, Tier 2, and Tier 3 matters that you will need to support to resolution. You understand that every customer is different and can move swiftly towards a resolution.

Manage to the member's communication preferences as possible, which may include time of day, channel, and language; utilize interpreter service as needed

Collaborate with our partners including but not limited to other departments, supplemental benefit vendors, and provider network to facilitate the member experience.

Excel in customer service and contribute to a culture of going above and beyond to ensure the highest level of member satisfaction.

Minimum Requirements for the position :

Language Skills : Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.

Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.

Mathematical Skills : Ability to add and subtract two-digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance.

Reasoning Skills : Ability to apply common sense understanding to carry out detailed, but un-involved written or oral instructions.

Ability to deal with problems involving a few concrete variables in standardized situations.

Basic understanding of Microsoft Office Products; Word, Powerpoint, Excel, etc.

Computer literate, typing 40+ words per minute.

What will earn you brownie points?

Experience helping members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations

Experience helping members navigate their Medicare Advantage benefits including medical, prescription drug, and supplemental benefits

Outbound call center experience which may include welcome / onboarding, appointment scheduling, retention, sales, or other health care / health plan related programs;

and / or inbound call center experience that indicates a higher level of problem-solving such as escalation or resolution

Must be available to work full-time and over-time through the Annual Enrollment Period (Oct-Dec) and Open Enrollment Period (Jan-Mar)