Customer Service Advisor providing resolutions for banking customers via multiple channels. Enhancing digital capabilities and collaborating with internal teams for accurate service delivery.
About the role
- Customer Service Representative assisting members with health insurance inquiries via phone. Documenting transactions and ensuring compliance while supporting contact center projects.
Responsibilities
- Communicates with members by phone to provide information about their respective health insurance plan services.
- Offers guidance, support, and educational services on non-clinical matters related to the different plan coverages and promotions.
- Manages incoming calls and refers them to the appropriate resources based on the member’s specific needs.
- Documents and records transactions, including details of inquiries and actions taken.
- Refers unresolved customer complaints to a supervisor or designated departments for further investigation.
- Supports other Contact Center projects.
- Conducts outbound phone interviews with members regarding services, satisfaction levels, and follow-up activities.
- Participates in training and development sessions.
- Ensures confidentiality and compliance with all applicable state and federal health call center regulations, including HIPAA and internal policies for handling confidential information.
- Immediately reports any Protected Health Information (PHI) exposure to the supervisor.
- Complies with core and functional trainings, as well as all procedures established by regulatory agencies, contractual requirements, and applicable certification standards (including but not limited to URAC).
Requirements
- Minimum of one (1) year of experience in Customer Service.
- Completed high school and/or university credits (preferred).
- Advanced knowledge of computer applications and/or Microsoft Office.
- Strong customer service orientation and commitment.
- Excellent verbal and written communication skills.
- Fast documentation and internet navigation skills.
- Availability for rotating shifts (including weekends/holidays), Monday to Sunday from 8:00 a.m. to 8:00 p.m.
Benefits
- Training in service, regulatory aspects, and healthcare.
- 24/7 Telemedicine service.
- Free employee health and wellness programs.
- Opportunities for growth and development.
- Contributing to the health and well-being of the population.
- Paid leave benefits.
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