Job Description

This position provides high-level member assistance as first critical contact by appropriately scheduling appointments through complex appointment making applications, transferring calls appropriately, composing messages, and providing general information.

Essential Responsibilities:

• Operates in a high volume, highly structured environment by responding to incoming calls, applying critical thinking to complex guidelines, and using multiple call center specific systems.
• Determines the type of appointment requested or needed, reviews scheduling mix of various physicians/providers, and then makes appointment following appropriate guidelines.
• Prioritizes member needs and offers alternatives to members when appropriate.
• Utilizes superior customer service skills to provide service to members when diffusing difficult member encounters.
• Uses tact and diplomacy in handling difficult interactions with members.
• Determines if calls are urgent or emergent by listening to the member, and following established guidelines, and then transferring the call to a Registered Nurse when appropriate.
• Composes messages for physician/providers, Registered Nurses or other medical staff based on members requests.
• Responds in a courteous and professional manner to general questions, using on-line databases to provide information to any member or other personnel calling the center.
• Identifies ways to improve quality of service to members and recommends steps used to accomplish these changes.
• Must perform all of the above duties while meeting established standards of performance for quality and productivity.
• Performs other clerical duties as assigned.
• Promotes, ensures, and improves customer service to internal/external customers by demonstrating skills which are consistent with the organization's philosophy of providing extraordinary customer relations and quality service.
• Performs other related duties as required.

Basic Qualifications:

Experience

• One (1) year customer service experience in a service related industry, preferably healthcare.

Education

• High school graduate or General Education Development (GED) equivalent.

License, Certification, Registration

• N/A

Additional Requirements:

• All testing must be completed by the end of the posting period.
• All internal transfer applicants and external applicants for the Customer Service Representative position are required to pass the job related assessment.
• Bilingual (English/Spanish) Level I required.

Preferred Qualifications:

• N/A

Notes:

• Must successfully pass or have passed the bilingual test (within the last 12 months), or be active in the QBS program.

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