Description & Requirements
- π Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching.
- ποΈ Paid Time Off Package - Enjoy PTO, Holidays, and sick leave,
- π± Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP).
- π Recognition Platform - Acknowledge and appreciate outstanding employee contributions.
- π Tuition Reimbursement - Invest in your ongoing education and development.
- π Employee Perks and Discounts - Additional benefits and discounts exclusively for employees.
Essential Duties and Responsibilities:
- Interface with and refer complaints and/or inquiries to the appropriate departments, agencies, advocates, and/or client representatives.
- Maintain updated knowledge of managed care as it relates to client supported programs.
- Meet the established processing guidelines, protocols and contract requirements related to complaint processing and the handling of PHI/PII.
- Assist consumers in enrolling, disenrolling, and transferring into health plans, when appropriate.
- Perform other duties as may be assigned by the Complaint Unit Supervisor and/or Project Management.
- Meet all standards established for this position as outlined in the corresponding annual performance criteria and bonus template for this position.
- High school diploma or GED required and 1+ years of relevant professional experience required, or equivalent combination of education and experience.
- Must be fluent in English and specified secondary language.
- Handles more complex customer service inquiries and problems via telephone, recording consistent problem areas.
- May respond to email inquiries.
- Customer service is the primary function.
- Calls are non-routine and require deviation from standard screens, scripts, and procedures.
- Handles situations which may require adaptation of response or extensive research according to customer response.
- Uses computerized system for tracking, information gathering, and/or troubleshooting.
- May handle escalated or unresolved calls from less experienced representatives.
- Works on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understands implications of work and makes recommendations for solutions.