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

• Provides accurate, timely, and professional responses via telephone, electronic mail, or online chat to plan members or other external customers.

• Uses appropriate systems platforms to research and resolve plan member or customer inquiries and issues.

• Requests required data and information from internal business partners as necessary to respond to customer inquiries.

• Follows department/corporate inquiry documentation and reporting policies and procedures.

• Meets daily, weekly and monthly call center performance goals in respect to volume, metrics and service levels and quality.

• Interacts with others inside and outside the organization to resolve the inquiry/claim related problems.

• Redirects misdirected calls in an efficient and professional manner.

• Other responsibilities as may be required.

Qualifications

Basic Qualifications

• High school graduate or GED equivalent required.

• Prior Customer Service / Call Center experience.

• Exceptional communication skills and the ability to understand complex situations and to effectively handle escalated customer concerns.

• Ability to type a minimum of 35 words per minute.

• Analytical skills and the ability to read and interpret data.

• Demonstrated problem solving skills.

• Detail oriented and well organized.

• Ability to work independently and as a part of a team

• Ability to operate computer programs - Microsoft Word, Microsoft Excel, Microsoft PowerPoint

Preferred Qualifications

• Knowledge of managed care processes and health insurance coverage preferred

• Specific prior Customer Service / Call Center experience in a Managed Care Organization preferred

• 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, 2020

Naya Advisory Services, Inc. is an equal opportunity employer committed to a diverse and inclusive workplace.

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