Associate

Firstsource

1d•Remote

About The Position

This is a work-from-home position for a Customer Service Call Center Representative. The role involves handling member inquiries, representing the Health Plan by answering and documenting incoming contacts, and addressing complex calls related to specialized product lines. Responsibilities include responding with empathy to complaints and concerns regarding health plan benefits, account status, payment history, and medical services. The representative will initiate contact with appropriate personnel to gather information, evaluate data to resolve complaints, and document interactions according to procedure. The role also requires assisting the department in reaching call handling goals, first contact resolution goals, complaint resolution compliance, member retention, and making return contact as needed. Completing required training and certifications, understanding available tools, and effectively diffusing anger and tension are also key aspects of the position. The representative must maintain awareness of how performance affects members and be open to feedback and behavioral changes to improve performance. Additionally, the role requires answering Healthcare Member and Provider inquiries while simultaneously typing information into the computer system.

Requirements

Must have Internet to include a router with Ethernet jack for connectivity to PC (Subject to change: FS Guidelines 25down/15 up min; BCBSM Guidelines 50 down/25 up min)
Must have a private workstation to perform your work
Must have quiet area free from distractions
Must have childcare/Family care, as you are unable to perform job and take care of child/children or family members
High School diploma or equivalent is required.
Substantial understanding of the job, apply knowledge and skills to complete a wide range of tasks.
Excellent written and verbal skills.
Problem-solving skills.
Basic knowledge of personal computers required
Strong reading comprehension and writing skills
Follow established procedures to meet customer needs.

Nice To Haves

Call center experience preferred.
Health insurance experience
2 years customer service experience preferred
Minimum typing speed = 30-35 wpm preferred

Responsibilities

Be available to handle member inquiries.
Represent Health Plan by answering and documenting all incoming contacts to determine their nature, and respond to complex calls related to specialized product lines or ques.
Respond with empathy to complaints and concerns from members concerning health plan benefits, account status, payment history, and medical services.
Initiate contact with the appropriate health plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed.
Evaluate data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery.
Document according to procedure.
Assist department in reaching call handling goals, first contact resolution goals, complaint resolution compliance, member retention and making return contact as warranted.
Complete required training (including, but not limited to, annual certifications) and understand how to use tools available to recall necessary information.
Effectively diffuse anger, tension, and hostility, within regulatory guidelines.
Maintain awareness of the way performance and actions affect members.
Be open and receptive to feedback and change behavior to improve performance.
Be able to answer Healthcare Member and Provider inquiries and type information into the computer system simultaneously.