CSR / Enrollment Rep

Daily Responsibilities: 

• Responds to member and provider inquiries (phone written or walk in) regarding all aspects of business including claims in a professional timely accurate and caring manner while consistently meeting all guidelines.

• Responds to member provider and other inquiries via telephone correspondence or lobby walk-in while meeting all corporate guidelines and performance standards

• Demonstrates appropriate customer-care skills such as empathy active listening courtesy politeness helpfulness and other skills as identified

• Records investigates and resolves member complaints as detailed in the Grievance Procedure narrative

• Assists in the education of new members and in the re-education of existing members regarding health plan procedures

• Logs tracks and appropriately documents all issues utilizing on-line systems and procedures and in accordance with all applicable guidelines and requirements

• Makes decisions that are consistent with the concept of a win-win-win for members associates 

• Demonstrates based behaviors such as initiative accountability and value

• Performs skills necessary to create a high-quality customer experience as reflected through acceptable C-Sat scores quality monitors and member feedback

• Performs other duties as assigned.