Customer Service - Senior Customer Service Representative
Tulsa, OK, United States
JOB SUMMARY:
Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibility, PCPs, claims and other questions. You will handle complaints, troubleshoot problems and provide resolutions in a professional and polite manner to ensure first contact resolution and customer satisfaction. Handle calls from multiple lines of business, assist in multiple communication channels or accept assignment of responsibilities above the skillset of the Customer Service Representative position.
KEY RESPONSIBILITIES:
Process a high volume of incoming inquiries regarding multiple products from members, providers, billing companies, individuals with legal representation, employer groups, and other insurance companies.
Quickly and effectively solve customer challenges.
Handle calls from multiple lines of business, assist in multiple communication channels or accept assignment of responsibilities above the skillset of the Customer Service Representative position.
Highly organized with an aptitude for details.
Interfaces with team members, management, and customers in reference to customer service issues.
Handle inbound and outbound calls, accountable for the delivery of high-quality professional services in accordance with the mission, core values and purposes of the company.
Serve as mentor for new hire CSRs and demonstrate professional demeanor as role model.
Verifies eligibility, benefits, deductible amounts, claim status, copays, coinsurance and all other information related to a customer and their benefits or a provider and their contract.
Use effective listening skills to understand the needs and complaints of the customer to offer them the best possible solution and ensuring the member feels supported and valued.
Resolve escalated customer issues received from the member, provider, employer groups or brokers while remaining calm and professional.
Effective problem resolution skills that demonstrates balance of company and customer needs.
Demonstrated ability and learning agility to adapt to organizational changes including business processes, systems and technology.
May be asked to be the lead worker in managing Team Open Logs.
Perform other duties as assigned.
QUALIFICATIONS: Exceptional telephone manner, customer service skills, active listening skills, verbal and written communication skills.
Ability to resolve conflict and diffuse tension.
Ability to work with and collaborate with others, including management, Team Leader and Customer Service Support Specialists.
Strong time management skills and decision- making skills.
Ability to work under stress with production and quality standards.
Proficient in Microsoft Office applications.
Highly organized and attentive to detail.
Flexibility, ability to adapt to change.
Successful completion of Health Care Sanctions background check.
Bilingual skills a plus.
EDUCATION/EXPERIENCE: High school diploma or equivalent required.
Minimum two years customer service experience with direct interactions with customers or equivalent educational experience.
Contact center or medical field experience preferred.
CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin
Other details Job Family Commercial
Pay Type Hourly
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