Customer Service Representative I - LBS

Lifetime Benefit Solutions•Rochester, NY

12h

About The Position

The Customer Service Representative resolves customer inquiries via telephone, fax, off-phone work, and email concerning, but not limited to, account benefits, claim payments, and enrollment in accordance with Operational Risk Audit (ORA), HIPAA, and other legislative requirements. This role requires participation in training immediately upon hire to become proficient in one line of business to independently perform the duties outlined below. Training in the second line of business must be initiated and completed within 12 months of proficiency in the first line of business to cross-functionally support the department. Initial line of business will be determined by the area of greatest need at time of hire. The position has two levels, Level I and Level II, with Level II building upon the responsibilities and qualifications of Level I, including providing expertise, support, mentoring, coaching, and guidance to other advocates, and assisting with job shadowing and new employee training for multiple lines of business.

Requirements

High School diploma or equivalent.
Strong communication skills across multiple channels including, but not limited to, voicemail, email, outbound calls, etc.
Adept at communicating effectively and diplomatically while working as a collaborative team member.
Strong organizational skills and ability to prioritize, work in fast paced environment, and remain professional and focused under multiple pressures and demands.
Ability to efficiently resolve customer concerns by actively listening to the customer, navigating screens on the computer, typing call documentation, and speaking to the customer simultaneously.
Excellent computer skills required, including the ability to navigate in a Windows environment.
Skillful at working between multiple programs and applications at the same time.
Proven reasoning and problem-solving skills.
Ability to work occasional overtime as required to meet business needs.
Performance rating of “Performing” or above in Level I for a consecutive 12 month period (for Level II).
Must be consistently proficient in all ancillary products (for Level II).
Ability to support specialized Groups to provide custom rules and regulations as applicable based on multiple lines of business (for Level II).
Proven ability to efficiently resolve complex and escalated issues with minimal direction (for Level II).
Advanced system and navigational skills (for Level II).
Demonstrated global thinking and initiative to recognize opportunities within the team (for Level II).

Nice To Haves

Customer service experience preferred.

Responsibilities

Researches, documents, interprets, and responds to inquiries from internal and external customers, business partners, and special groups concerning our products, services, and policies in accordance with ORA, HIPAA, and other legislative requirements.
Researches and responds to questions related to claims, onboarding, effectuation, retention, provider inquiries, and any other complex inquiry.
Identifies and follows through on issues impacting the Health Plan and customer experience.
Provides service to customers and business partners while responding in a professional, efficient, and timely manner to enhance member and provider satisfaction and retention.
Must exercise tact, patience, and professionalism at all times in responding to internal/external customers.
Utilizes appropriate resources to resolve customer inquiries accurately & efficiently, resulting in acceptable quality, First Call Resolution, and performance.
Develops effective internal working relationships for improved communication and collaboration.
Shares ideas and solutions to improve processes, procedures, and systems.
Participates in meetings, training, and skill development to support career path and individual development plans.
Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.
Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
Regular and reliable attendance is expected and required.
Performs other functions as assigned by management.
Provides expertise, daily support, mentoring, coaching, and guidance to other advocates (Level II).
Assists with job shadowing and new employee training for multiple lines of business (Level II).