Customer Service Rep - Processing Center

Position Summary:

Responsible for providing support services in handling incoming telephone calls, mailings, emails and other forms of electronic communications from our clients and their members participants. Demonstrates professional and effective communications and interactions with callers and their questions or inquires. Handles very sensitive and confidential information that must be entered accurately and appropriately, and then store those documents into our document management systems and proprietary software tools.

Essential Duties and Responsibilities:

• Effectively and in a timely manner handles incoming telephone calls and participant inquires, responding based on predetermined scripts and guidance provided on similar circumstances. When necessary, escalates unusual or irate callers to a senior staffer.
• Handles responses from survey participants left on voicemail and follows up appropriately, logging the information into the REV system.
• Performs outbound calls to survey participants to obtain the required information to missing details not provided or unclear responses.
• Acquires knowledge of the eligibility rules and unique standard documentation requirements that are predetermined or modified for clients based on each plan’s specific eligibility verification criteria.
• Reviews and enters completed participant verification form responses and REV portal responses, and the new or corrected demographic information provided.
• Adept at scanning large numbers of paper forms and documents, keeping participant responses banded together and perfecting images for effective readability and interpretation of details.
• Assists in preparation and production of client mailings for any printing, stuffing and posting, including mail merging tasks, preparing custom forms and postcards Helps to identify when address information is incorrect or incomplete.
• Adheres to all confidentiality agreements associated with data and documents received, and to exercise the necessary precautions in the communication and use of the data, including confidentiality of conversation with participants.
• Fields any incoming Spanish and other non-English calls and obtains real-time assistance from our Spanish speakers on duty.
• Occasionally handles front desk reception duties, greeting visitors in the main reception or other meeting areas.
• Performs other duties as assigned or as business needs are changed or expanded.

Skills and Attributes:

• Effective communication skills and customer services skills.
• Skilled in using Microsoft Windows (current version), Microsoft Office and familiarity with a variety of other computer software programs.
• Ability to utilize basic office equipment and provide maintenance as needed, or notify management if equipment is not working appropriately.
• Ability to work in a team environment and to participate in various projects as needed.
• Possess and demonstrate excellent data entry skills. Must be very attentive to details and exceptionally accurate.
• Must be able to handle confidential and sensitive information securely and appropriately.

Education/Certification/Experience:

• Two or more years of experience in a related field or an office environment, handling administrative and data entry functions such as inputting eligibility records into computer database systems.
• Excellent oral and written communication skills.
• Experience in the health care industry a plus.
• Familiarity with general computer systems and the ability to quickly learn custom software.