Description & Requirements
What you will receive:
π Work/Life Balance Support β Flexibility tailored to your needs!
π° Competitive Compensation β Bonuses based on performance included!
π‘Comprehensive Insurance Coverage β Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance.
π Future Planning β Prepare for retirement with our 401K Retirement Savings plan and Company Matching.
ποΈ Paid Time Off Package β Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage.
π± Holistic Wellness Support β Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP).
π Recognition Platform β Acknowledge and appreciate outstanding employee contributions.
π Diversity, Equity, and Inclusion Initiatives β Join a workplace committed to fostering diversity and inclusion.
π Tuition Reimbursement β Invest in your ongoing education and development.
π Employee Perks and Discounts β Additional benefits and discounts exclusively for employees.
π Maximus Wellness Program and Resources β Access a range of wellness programs and resources tailored to your needs.
πProfessional Development Opportunities: Participate in training programs, workshops, and conferences.
Essential Duties and Responsibilities:
- Interface with clients and refer complaints or inquiries to appropriate departments, agencies, advocates, or client representatives.
- Stay updated on managed care relevant to supported client programs.
- Adhere to processing guidelines, protocols, and contract requirements for complaint processing and handling PHI/PII.
- Assist consumers in health plan enrollment, disenrollment, and transfers when necessary.
- Fulfill assigned duties directed by the Complaint Unit Supervisor or Project Management.
- Meet performance standards outlined in the annual criteria and bonus template for the position.
- Address complex customer service inquiries and problems over the telephone, noting consistent issues for resolution.
- Potentially respond to email inquiries.
- Prioritize customer service as the primary function, handling non-routine calls requiring deviation from standard procedures.
- Manage situations needing adapted responses or extensive research based on customer needs.
- Utilize computerized systems for tracking, information gathering, and troubleshooting.
- Handle escalated or unresolved calls from less experienced representatives.
- Tackle moderately difficult assignments, exercising judgment in issue resolution and recommending solutions.
- High school diploma or GED required and 1+ years of relevant professional experience required, or equivalent combination of education and experience.