NEW JOB OPENING
CUSTOMER SERVICE REPRESENTATIVE
IN Denver, CO, USA!

• **Only those lawfully authorized to work in the designated country associated with the position will be considered.**

• **Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.**

Estimated Start Date: 6/24/2024
Work Model: Remote - MUST BE LOCATED IN DENVER, CO AREA
Training Shift: 8:00 AM - 4:30 PM MT
Nesting Shift: 9:30 AM – 6 PM MT

Skills Assessments: Required

Training:
* Training will be for 3 months. (No time off will be approved during the first 90 days).
* Training Hours- Will Vary: Need to be flexible to work until 9pm EST and weekends.
* Worker will be remote - Must have internet speeds and quiet place for remote work (Hardwired-no hotspot)

Additional Job Details:
* It is expected for workers to be in attendance daily during/after training. Time off during assignment will be sparse.
* The Member Service Contact Center (MSCC) operates: Monday – Friday 7:00AM – 9:00 PM and Saturday and Sunday 8:00AM to 7:00PM. Pacific Time.

Education Qualifications:
* High School Diploma or General Education Development (GED) required.

Basic Qualifications:
* Minimum two (2) years of customer service experience.
* Excellent written and verbal communication skills.
* Demonstrated analytical and problem-solving skills.

The Customer Service Representative is responsible for increasing customer satisfaction and retention by providing members, customers, patients and providers with accurate, consistent, timely and meaningful information.
* They will provide support to members' inquiries and issues as they utilize the Client plan and provider services, continuing to build rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines.

Additional Responsibilities:
* Available to handle member inquiries regarding:
* Member Core: Facility Inquiry, Web Support, Promote Client, Order ID Card, Complaint, ID Card Inquiry, Service Review.
* Member Advance: Eligibility Inquiry, Benefit Inquiry, General, Complaint, Correspondence Inquiry, Add/Remove Dependent, Service Review, New Member Experience, Internal Regional Request, IVR Defaults. Medicare (For up to two (2) regions).
* Premium Billing Enterprise: Billing Inquiry, Make Payment, Complaint, EFT Inquiry, General, Reinstatement Request, Service Review. Client Billing, 1095 Tax Form, SLP* (escalations to Tier
* Represents Health Plan by answering and documenting all incoming contacts to determine their nature and to respond to complex calls related to specialized product lines or queues.
* Responds professionally to inquiries from internal/external customers.
* Promotes, ensures and provides customer service to internal/external customers by demonstrating skills which are consistent with the organization's philosophy of providing extraordinary customer relations and quality service.
* Initiates contact with the appropriate Health Plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed.
* Evaluates data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery.
* Documents conversations with members according to procedure.
* Follows established procedures to meet customer/member needs.
* Required to effectively interact with diverse work units and relevant organizational departments.
* Has substantial understanding of the assigned skills and applies knowledge and skills to complete a wide range of tasks.
* Ability to understand relevant policies, processes and customers.
* Assist the department in meeting customer needs and reaching department expectations.
* Completes required training and understand how to use tools available to recall necessary information.
* Develop a full awareness of the way performance and actions affect members and Member Service.
* Contact Center's (MSCC) performance guarantees (call handling, first call resolution, complaint resolution compliance, member retention, and return contact as warranted).
* Consistently supports compliance and the Principles of Responsibility (Client Code of Conduct) by maintains the privacy and confidentiality of information and protects the assets of the organization.
* Performs other relevant duties as required.