Call Center Service Associate

Responsibilities:

- Receive customer inquiries via phone, fax, mail, e-mail, etc. If necessary, probe for additional helpful information (i.e. member ID, claim number, name, etc.) in order to effectively handle inquiry.

- Review computer systems and/or other reference materials to complete verification process.

- Initiate investigation process based on the nature of the inquiry (claim, member information, benefits, enrollment, appeals, etc.).

- Utilize available resources to quickly and efficiently resolve or redirect inquiries in accordance with prescribed departmental process.

- Accurately document customer inquiries and actions taken in accordance with departmental quality guidelines to ensure appropriate follow up.

- Follow up on unresolved issues in a timely manner, escalating call trends to management.

- Deliver an excellent customer service experience while meeting quality and production standards.

- Perform other relevant tasks as assigned by management.



Qualifications:

Education/Experience: High school degree or equivalent required. Some college preferred. Some experience in a call center or customer service role within the health insurance industry required.





Skills and Abilities:

- Excellent Customer Service skills including the ability to manage and diffuse irate calls

- Ability to work in a high pressure, fast pace environment

- Keyboarding proficiency

- PC proficiency

- Strong verbal and written communication

- Interpersonal skills (i.e. active listening)

- Investigative and analytical skills

- Ability to multitask

- Time management skills

- Flexibility and adaptability

- Ability to work effectively within a team environment