Membership Service Advocate

Detalles de la oferta

.About UsHelpware is a technology-driven company with offices in the USA, Ukraine, Mexico, and the Philippines which provides Customer Experience & Operational Support for modern companies. Our team of professionals is driven by the purpose of providing best-in-class value-adding services to our partners by leveraging our empowered teams, innovative solutions, and technologies.Position Summary:As a Member Services Advocate, you will be a part of a team that transforms customer service into Customer Care by delivering an amazing experience. You will assist beneficiaries with a wide range of critical services, which include but are not limited to updating account information, providing plan information, and resolving issues with utilization of the plan. Qualified candidates will have a strong desire to help people with strong customer care skills, attention to detail, and highly organized.Responsibilities:Update account information such as billing options and changes of address or phone numbers.Research premium billing discrepancies and prescription claims processed.Educate beneficiaries on how the plan works, including benefits, cost sharing, and levels of coverage.Submit mail requests for beneficiaries such as ID cards and formularies.Look up medicines on the formulary to verify if they are covered, the tier and copay level, and if a drug is not covered, provide an explanation as to why.Display a positive demeanor, technical accuracy, and conformity to company policies.Understand CMS Guidance and ensure applicable Exhibits are being mailed per CMS Guidance.Ensure HIPAA regulations are maintained within the immediate environment.Responsible for concise and detailed notations as it pertains to member records.Handle outbound calls for purposes of validating information.Handle inbound calls by assisting members with a high level of accuracy and efficiency.Escalate any member issues to management as necessary.Maintain a high level of call quality as set by client standards, which includes a 95% quality score, and answering 80-85% of calls within 30 seconds or less.Communicate with coworkers, management, staff, customers, and others in a courteous and professional manner.Conform with and abide by all regulations, policies, work procedures, and instructions.Respond promptly when returning telephone calls and replying to correspondence and faxes.Act, dress, and behave in a professional manner to reflect a positive image of the company.Monthly Goals:Meet average QA score of 95%Comply with attendance guidelines of 98%Schedule adherence of 90% or higherMaintain AHT below certain standardsRequirements:Associate Degree preferably in Healthcare.Minimum 3 years working in a fast-paced high-volume call center environment, retail customer service, preferably in healthcare or hospitality.Ability to multi-task effectively with strong attention to detail when documenting customers' reasons for calling.Excellent written communication skills


Salario Nominal: A convenir

Fuente: Jobtome_Ppc

Requisitos

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