Job Description :
This job handles customer inquiries by telephone and/or email and/or in person from individual members, groups, providers and brokers in a customer service center. Troubleshoots and resolves customer complaints. Ensures that responses to inquiries are completed timely and according to established service and quality standards.
- Resolve customer inquiries and complaints via written, telephonic and face-to-face communication in a timely and accurate manner.
- Prepare adjustments for services not properly processed, either systematically, or by forwarding to the appropriate area for follow up and resolution.
- Meet all production, quality, and adherence standards. Attends all required training classes.
- Elevate issues to next level of supervision, as appropriate.
- Maintain accurate records, including timekeeping records.
- Other duties as assigned or requested.
- High School Diploma or GED
- 1 year of customer service experience in a call center preferred with healthcare customer service strongly preferred
LICENSES or CERTIFICATIONS
- Knowledge of principles and processes for providing customer service, including customer needs assessment and meeting standards.
- Ability to handle many tasks simultaneously and respond to customers and their issues promptly and professionally.
- Ability to take direction and to navigate through multiple systems simultaneously.
- Ability to maintain composure under stressful and fast-paced conditions.
- Strong written and verbal communication skills
- Ability to communicate complex information in a simple, customer facing way
Language (Other than English):
0% – 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Teaches/Trains others regularly
Travels regularly from the office to various work sites or from site-to-site
Does Not Apply
Works primarily out-of-the office selling products/services (Sales employees)
Does Not Apply
Physical Work Site Required
Lifting up to 10 pounds
Lifting 10 to 25 pound
Lifting 25 to 50 pounds
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and Applicants Notice