Customer Service Representative
Position Title
Customer Service Representative (CSR)
Position Description
Under general supervision, uses specialized health plan knowledge to provide professional, efficient, and customer-focused service in support of the health plan memberinquiries involving claim, benefit, membership, and/or billing.
Creates a positive first impression by providing knowledgeable answers to questions and directs callers appropriately.
Responsibilities
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Provides accurate, timely, and professional responses via telephone, electronic mail, or online chat to plan members or other external customers.
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Uses appropriate systems platforms to research and resolve plan member or customer inquiries and issues.
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Requests required data and information from internal business partners as necessary to respond to customer inquiries.
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Follows department/corporate inquiry documentation and reporting policies and procedures.
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Meets daily, weekly and monthly call center performance goals in respect to volume, metrics and service levels and quality.
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Interacts with others inside and outside the organization to resolve the inquiry/claim related problems.
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Redirects misdirected calls in an efficient and professional manner.
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Other responsibilities as may be required.
Qualifications
Basic Qualifications
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High school graduate or GED equivalent required.
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Prior Customer Service / Call Center experience.
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Exceptional communication skills and the ability to understand complex situations and to effectively handle escalated customer concerns.
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Ability to type a minimum of 35 words per minute.
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Analytical skills and the ability to read and interpret data.
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Demonstrated problem solving skills.
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Detail oriented and well organized.
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Ability to work independently and as a part of a team
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Ability to operate computer programs - Microsoft Word, Microsoft Excel, Microsoft PowerPoint
Preferred Qualifications
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Knowledge of managed care processes and health insurance coverage preferred
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Specific prior Customer Service / Call Center experience in a Managed Care Organization preferred
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Bilingual in Spanish and English preferred
Classification: Full-time with Benefits
Work Location: Detroit, MI
Work Hours: Monday – Friday, 7:00AM – 4:00PM
Hours per week: 40
Position Requisition #: 5187
Date Posted: April 19, 2019
Naya Advisory Services, Inc. is an equal opportunity employer committed to a diverse and inclusive workplace.