Two Chicks With A Side Hustle

Serve as the day-to-day frontline support for members and authorized representatives to provide choice counseling and support with enrollments, disenrollments, and appeals. 
· De-escalate issues as appropriate and properly document all call center contacts. 
· Assist with Outbound follow up calls and working manual tasks as needed. It is critical that Customer Service Enrollment Specialists focus on Quality, Accuracy and Adherence while ensuring the program is meeting contractual requirements. 

  • Handle high volume inbound calls supporting members with choice counseling when selecting the most appropriate health care plan to meet their needs. 
  • Accurately document member information and call notes. 
  • Provide accurate information and provide a positive experience to all callers, including potential Providers and local county offices in addition to members and/or authorized representatives. 
  • Complete outbound follow up calls as appropriate. 
  • De-escalate callers when handling complaints and/or grievances, escalating if appropriate. 
  • Handle up to three (3) incoming chat sessions from members and/or authorized members to answer questions, or assist with enrollments, disenrollments and appeals. 
  • To meet HIPAA guidelines this position may need to review PHI details. 
  • Complete offline work tasks as needed. 

Required Qualifications: 

  • High School Diploma (or GED equivalent) is required; Associate Degree is preferred. 
  • 1-3 years of inbound call center customer service experience is required, healthcare is preferred. 
  • Demonstrated ability to remain positive and professional during stressful periods. 
  • Ability to work in a high-speed environment. 
  • Attention to detail. 
  • Knowledge of Medicaid is a plus. 
  • Proven ability to effectively multi-task, and complete work timely and accurately. 
  • Proficient typing skills with attention to accuracy and quality are essential. 
  • Solid computer skills including Excel, Microsoft Word and Outlook. 
  • Solid verbal and written communication skills. 
  • Must be able to read and interpret policies, procedures and instructions.

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