With minimal supervision, provide education and assistance to internal and external customers in a manner that support the achievement of the company’s satisfaction, growth, and operational excellence goals. Act as a first point of contact in addressing the complex and escalated customer concerns related to changes within our family of companies and lines of business (LOBs). Respond to routine and complex telephone or written inquiries from members, doctors, clients and consumers; effectively position messages in a manner that is supportive of divisional and corporate strategies as necessary to ensure appropriate resolutions. Contingent on the Line of Business (LOB), requires in-depth knowledge in the following areas: Prescriptions, Plans, Products, Services, and Procedures; Online purchasing & e-Commerce knowledge; Internet knowledge; Payment processing/payment collections; Eligibility verification; Order Status, Shipping Status, and Stock Availability; Accurate completion of necessary documentation, letters, and forms processing. Demonstrate confidence and skill in guiding customers in arriving at solutions that are supportive of strategic initiatives. Identify and analyze trends and communicate to appropriate business partners. Suggest necessary corrections, changes or solutions. Appropriately elevate situations that could have broader customer or business impacts. Utilize in-depth knowledge of policies, procedures, medical terminology, telephone and writing techniques. Remain current on all changes to policy, procedure and product information to accurately and consistently respond to inquiries. Maintain and organize correspondence to ensure consistent, accurate and professional responses. Recommend updates to on-line knowledge management tools to clarify policy and procedures when conflicting information exists. May make recommendations or create new content. Assist leadership staff in providing coaching and policy or procedural support to CSRs as applicable. Document performance opportunities acquired through escalated calls or frequent agent interactions, (compliments/complaints/coaching opportunities), and provides to appropriate Supervisor. Contingent on the LOB, may create and manage assignments of monthly audit inventory. Contingent on the LOB, may assist in the functions around complaint and grievances, such as monitoring compliance, reporting, etc. Contingent on the LOB, may assist in Identifying technical issues through problem duplication and manipulation of customer data to provide details to the software development team for product correction and improvement. May be required to utilize multiple hardware and software tools to troubleshoot a variety of issues.
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Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
501-1,000 employees