Job Description
Job Description
Position Summary: This position is responsible for addressing customer inquiries, resolving issues, and providing excellent customer service to our health plan members. This is an entry-level position, and the ideal candidate will have a strong desire to learn and grow within the company.
Essential Duties and Responsibilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
· Respond to customer inquiries via phone, email, or chat.
· Resolve customer issues and concerns in a timely and professional manner.
· Provide accurate and up-to-date information on health plan policies, procedures, and benefits.
· Document customer interactions and resolutions in our database.
· Escalate complex issues to higher-tier representatives as needed.
· Follow up with customers to ensure issues are resolved to their satisfaction.
· Identify and address any potential issues or concerns proactively.
· Collaborate with internal departments to resolve customer issues.
· Maintain up-to-date knowledge of health plan policies, procedures, and industry trends.
· Participate in training and development programs to improve knowledge and skills.
· Contribute to the development of customer service strategies and procedures.
Competencies:To perform the job successfully, an individual should demonstrate the following.
Adaptability: Demonstrates openness to change and new ideas. Adapts to different situations and adjusts behavior accordingly. Manages multiple tasks and priorities effectively. Communication: Listens actively and asks relevant questions to understand needs. Expresses thoughts clearly and concisely both verbally and in writing. Maintains effective working relationships with colleagues and clients. Selects appropriate communication methods based on context.
Cooperation: Shows a cooperative attitude and works collaboratively with others. Establishes trustworthy relations with colleagues and clients. Displays empathy and tact when interacting with sensitive topics. Offers support and assistance to colleagues and clients. Resolves conflicts constructively and efficiently. Works well in group problem-solving situations.
Customer Service: Demonstrates caring and sensitivity towards customers. Addresses customer concerns promptly and courteously. Meets commitments and deadlines. Solicits customer feedback to improve service delivery.
Dependability: Commits to fulfilling responsibilities and obligations. Follows instructions carefully. Adheres to attendance and punctuality guidelines. Takes responsibility for actions and decisions. Problem Solving: Generates creative solutions to complex problems. Gathers and analyzes information critically. Identifies potential problems early on. Solves problems effectively using available resources. Collaborates with peers to solve difficult problems.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education/Experience:
- High school diploma or equivalent required.
- 0-2 year of experience in healthcare customer service, administration, or a related field. Proven track record of providing excellent customer service, including resolving customer complaints and exceeding expectations.
Skills:
- Strong communication and interpersonal skills, with the ability to listen actively, empathize with customers, and communicate clearly and concisely.
- Ability to work effectively in a fast-paced environment, managing multiple tasks and priorities simultaneously.
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and customer service software applications.
- Strong attention to detail and organizational skills, with the ability to maintain accurate records and reports.
- Demonstrated problem-solving skills and ability to think critically and creatively
- Ability to work independently and collaboratively as part of a team.