Customer Service - Customer Service Representative 105
CommunityCare
- Tulsa, OK
- Permanent
- Full-time
- 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.
- Strive to achieve first call resolution by communicating accurate information efficiently and timely thereby creating a positive experience for the member.
- 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.
- Provide interpretation services for all product lines via the contracted language line service as appropriate.
- Flexible hours, including weekends and evenings, as department or training needs dictate and at the discretion of management may be required.
- 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.
- Joining a team of Customer Service Representatives and building a positive relationship of teamwork, trust, reliability and excellence.
- Understanding and striving to meet or exceed call center metrics while providing excellent customer service.
- Taking part in training and other learning opportunities to expand knowledge of company and position.
- Perform other duties as assigned.
- Exceptional telephone manner, customer service skills, active listening skills, verbal and written communication skills.
- Ability to resolve conflict and diffuse tension
- Strong time management skills and decision- making skills.
- Ability to read, comprehend, and explain health insurance benefits in a clear, concise, and professional manner.
- 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.
- High school diploma or equivalent required
- 1-year customer service experience with direct interactions with customers
- Contact center or medical field experience preferred