Job Brief:

The Inbound Call Center Representative (CSR) answers all incoming calls from sponsors, members, and providers. Researches claim status, and assists in bringing resolution to the claim problem by thorough analysis. To do this, the CSR must have a thorough understanding of the claims process to ensure repeat calls do not occur due to unclear or inaccurate information. Outbound calls are made by the CSR to close the communication loop with the caller as required and the CSR must manage this process to coincide with lulls in call center inbound call volumes.


Responsibilities:

- Handle high volume inbound calls supporting members with counseling when selecting appropriate health care plans to meet their needs
- Accurately document member information and call notes
- Provide members with accurate information and a positive experience to all callers (callers may also include local county offices)
- De-escalate callers when handling complaints and escalating when appropriate
- Handle up to 3 incoming chat sessions simultaneously
- Complete offline work as needed

Skills Required:

- Accuracy and attention to detail
- Ability to work in a fast paced environment
- Excellent listening skills
- Ability to manage callers with compassion and professionalism