Customer Service Representative--Troy
|Company:||Dialog Direct||Location:||Troy, Michigan, United States|
|Posted:||Wednesday, February 24, 2016|
Customer Service Representative--Troy
|Benefits:||Medical, Dental, Vision, 401k|
|Employment Type:||Full Time|
Customer Service Representatives assist and educate members, employer groups, providers, colleagues, and or agents of health plan benefits with accessing services, facilitating and resolving problems, understanding claims, along with other questions. Consistently create an exceptional experience with each contact, via inbound and outbound calls, face-to-face interactions, online chat, email, etc.
|Duties:||� Analyzes, evaluates, resolves and responds to service inquiries from members, providers, employers groups, colleagues, agents, Elite agents (customers), and others within departmental guidelines. Professional and pleasant interactions are ongoing expectations.
� Partnering with internal and external resources promptly provides customers with information and education concerning benefit clarification, eligibility requirements, verification, authorization, billing and claim status.
� Promptly identifies and resolves or escalates customer concerns or complaints to achieve positive outcomes. Places outbound welcome calls to members to educate them on their benefits as needed. Assists walk-in-members and agents if assigned by leadership.
� Adheres to established procedure and quality guidelines in support of Priority Health service promise, key drivers, performance indicators, as well as corporate values and codes of excellence. Identifies potential trends or issues that impact health plan members and works with coworkers and leadership resources to suggest process improvements.
� Assists customers with administrative issues, such as submitting enrollment record changes, providing letter explaining coverage or benefits, and obtaining and relaying certain member information to other departments as needed.
� Facilitates claims resolution through follow-up on member calls and correspondence received to appropriate departments.
� Effectively tracks and/or documents all service interactions with customers within appropriate systems according to guidelines.
� Develops and maintains behaviors of productivity, availability to customers, and adherence to work schedule.
|Qualifications:||� Excellent written, verbal communication, and interpersonal skills
� Time management and organizational skills
� Ability to make quality, independent decisions
� Analytical and strong problem solving skills
� Ability to work effectively and efficiently under tight deadlines, high volumes and multiple interruptions
� Ability to listen to others
� Competency in the use of a variety of computer hardware and software systems
� Analyze, evaluate, resolve and respond to telephone inquiries from members (customers) within departmental guidelines.
� Have a strong customer service orientation to deliver an exceptional consumer experience consistently with every contact.
� Must have excellent listening skills.
� Must communicate clearly and effectively.
� Ability to take initiative and work independently.
� Individuals must be organized and able to perform multiple tasks with a high degree of accuracy.
� Ability to effectively track all inquiries with complete documentation.
� Strong drive for First Call Resolution.
� Skill, knowledge, abilities typically gained through less than 2 years in customer service, manage care or billings required
� Successful completion of competency based orientation program required
� High School Diploma or equivalent required
� 1 year of college education with courses in science or health care preferred
� Associate�s Degree or equivalent preferred
About Dialog Direct
Dialog Direct provides end-to-end marketing and customer engagement solutions that create WOW experiences between brands and consumers. By combining technology with a passionate, innovative culture, we enhance each stage of the customer lifecycle with customer insights, digital and direct marketing, e-commerce and fulfillment, and customer service and sales solutions that build long-term customer relationships.
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