GENERAL DESCRIPTION OF POSITION
The Customer Service Representative I answers inbound calls and makes outbound calls to support Customer Service Department operations in a manner that maintains compliance with Medicare and Medi-Cal regulatory requirements and achieves Call Center service level objectives.
ESSENTIAL DUTIES AND RESPONSIBILITIES
To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below.
1. Answer inbound calls and/or place outbound calls in a high call volume environment and work directly with members and providers to answer inquiries involving program services and benefits accurately and completely.
2. Follow established guidelines and resources to respond to member and provider inquiries and resolve concerns in an accurate, timely, professional, and culturally competent manner.
3. Educate members and providers on benefits and how to access services in a manner that achieves excellent service standards and maintains high customer satisfaction.
4. Accurately document and categorize all contacts and follow-up actions regarding member and provider communications and activities in accordance with established guidelines.
5. Appropriately handle member and provider requests through alternative channels such as e-mail, voicemail, fax, walk-in, etc. in accordance with Call Center established procedures.
6. Attend and actively participate in daily, weekly, and monthly departmental meetings, in-services, training and coaching sessions.
7. Identify member/provider issues and trends and report relevant information to management.
8. Perform other related duties as required or assigned.
When applying, please note that you saw the job posted on the NOVA Job Board. If you need help with your resumé, please see a NOVA Career Advisor.