Job description

Shift: M-F 9AM - 5PM
Duties:

The Customer Services Representative provides comprehensive customer service to members, providers and prospective members. The primary responsibilities include but are not limited to documenting all customer contacts into the tracking system, process complaints, conduct outreach efforts, assist in PCP selection, conduct new member orientations, claims review inquiries, handle provider and utilization management inquiries, etc.

• Record and respond to all Customer contacts and update in tracking system. Manage and ensure appropriate follow-up and closure for all customer contacts.
• Provide on-site as well as telephone orientations to new and existing members.
• Process and resolve complaints and record given information in the system.
• Assist members with the selection and assignment of PCP’s.
• Update all member demographic changes.
• Provide all benefit/service related information to members, perspective members and providers.
• Perform retention efforts for all lines of business.
• Handle roster Inquiries
• Handle disenrollment inquiries from members, providers and regulatory agencies.
• Handle provider inquiries.
• Schedule marketing appointments for prospective enrollees
• Respond to all claim billing inquiries from providers and members

Skills:

• Record and respond to all Customer contacts and update in tracking system. Manage and ensure appropriate follow-up and closure for all customer contacts.
• Provide on-site as well as telephone orientations to new and existing members.
• Process and resolve complaints and record given information in the system.
• Assist members with the selection and assignment of PCP’s.
• Update all member demographic changes.
• Provide all benefit/service related information to members, perspective members and providers.
• Perform retention efforts for all lines of business.
• Handle roster Inquiries
• Handle disenrollment inquiries from members, providers and regulatory agencies.
• Handle provider inquiries.
• Schedule marketing appointments for prospective enrollees
• Respond to all claim billing inquiries from providers and members
• All other duties and special projects as assigned by Associate Executive Director

Professional Competencies:

• Integrity and Trust
• Customer Focus
• Functional/Technical skills
• Written/Oral Communication

Job Types: Full-time, Contract

Salary: $20.00 - $22.00 per hour

Schedule:

• 10 hour shift
• 8 hour shift
• Monday to Friday

Work Location: One location

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