Functions & Job Responsibilities
- Educates members, family, providers and caregivers regarding benefits and plan options.
- Accurately explains benefits and plan options in person, via email, fax, or telephonically.
- Provides follow-up with members by clarifying the customer’s issue, determining the cause, and identifying and explaining the solution. Escalates appropriate member issues to management or other departments as required.
- Provides follow-up with members by clarifying the customer’s issue, determining the cause, and identifying and explaining the solution. Escalates appropriate member issues to management or other departments as required.
- Participates in member calling projects as assigned by management to support the overall company's goal of membership retention.
- Follows policies and procedures and job aids in order to maintain efficient and complaint operations; communicates suggestions for improvement and efficiencies to management; identifies and reports problems with workflows following proper departmental procedures; actively participates in departmental staff meetings and training sessions.
- Follows all appropriate Federal and State regulatory requirements and guidelines applicable to Company Plan operations, as documented I company policies and procedures. Follows all HIPAA requirements.
- Documents transactions by completing applicable member forms and summarizing actions taken in appropriate computer system and following standards set by the department or by other authorized individuals.
- Ability to work in an environment where continuous coaching and feedback is the standard practice.
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Qualifications
- High school diploma or equivalent, Bachelor’s Degree preferred.
- At least 2 years customer service experience, preferably in healthcare management and/or a call center setting
- Bilingual in Korean/Mandarin/Cantonese/Vietnamese may be required.
- Exceptional customer service skills, including verbal and written communication
- Strong active listening skills
- Ability to collaborate and be a team player
- Must be a quick learner
- Ability to remain calm and courteous when handling upset members and offering solutions to their problems and knowing when to escalate the call
- Familiarity with Centers for Medicare and Medicaid Services (CMS) regulations, preferred
- Proficiency with Microsoft Office (Word, Excel, Outlook)
- Type 60wpm preferred
- Must be willing and able to work weekends from October-March
Job Type: Full-time
Salary: Up to Php90,000.00 per month
Benefits:
- Health insurance
Schedule:
- 8 hour shift
- Monday to Friday
- Night shift
Application Question(s):
- What foreign language can you speak?
- If you would rate yourself from 1 as the lowest and 10 as the highest, how would you rate yourself in foreign language skill you have:
Experience:
- Customer support: 1 year (Preferred)
Shift availability:
- Night Shift (Required)
Expected Start Date: 08/21/2023
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