OB SUMMARY:
Provides incoming and outgoing administrative support for the Customer Service Call Center to include intake, processing, routing and response to digital/electronic, and facsimiles communication. Completes timely documentation of requests and processing through the Managed Care Platform and data systems (QNXT & Salesforce). The E-service representative must possess content knowledge in (Medicaid/CHIP), Commercial, and Affordable Care Act products, analytical skills to quickly identify issues and resolve them within the desired timeframes. The E-service representative will be responsible for serving our customers in a multi-faceted work environment, to include, but not limited to communication via email, facsimiles, and chat. He or she will be completing customer requests to include, but not limited to primary care physician change, demographic updates, billing inquiries, and complex issues that include account research, reconciliation and the appropriate routing and resolution of member dissatisfaction and complaints. Maintain confidentiality of sensitive employee, customer and company data without exception.
JOB SPECIFICATIONS AND CORE COMPETENCIES
Essential Functions
50% Respond to customer inquiries by email, chat or sms to provide problem resolution and answer all Member questions or concerns
20% Document information into CRM system to track the interactions and solutions.
20% Maintains a professional behavior and exhibit excellent interpersonal and communication skills.
10% Other duties as assigned
Reports to Position Title: Customer Svc Center Supervisor
Employees Supervised Titles: N/A
MINIMUM QUALIFICATIONS:
Education/Specialized Training/Licensure:
- High School Diploma or GED or equivalent
Work Experience (Years and Area):
- Three years of experience in a customer service setting with high volume point of service contact.
- Individual should possess extensive knowledge of health insurance programs such as Medicaid, CHIP and Marketplace products.
Management Experience (Years and Area): N/A
Software Proficiencies: Microsoft Office (Word, Excel, Outlook)
Other:
- Strong analytical organizational, prioritization and time management skills.
- Ability to work efficiently, pay strict attention to details and deliver high quality results in a deadline driven environment, while effectively managing associated stress.
COMPETENCIES
Organizational Core Competencies: All employees are responsible for understanding and demonstrating Community Health Choice core competencies:
- Customer Focus
- Reliability and Dependability
- Honesty & Integrity
- Achievement Orientation
- Change Management
- Team Work
Job Family/Job Title Competencies
- Problem Analysis
- Attention to Detail
- Analytical Thinking
- Writing /Composing
- Medical terminology
INTERPERSONAL SKILLS
The following are examples: (Interact successfully in a team environment, communicate successfully in a diverse community, communicate effectively with individuals from varied experiences, perspectives and backgrounds, deal with individuals in a tactful, congenial, personal manner, etc.)
Excellent interpersonal, verbal, written, and listening communication skills.