Position Purpose: Performs as the advocate that focuses on resolving routine inquiries, issues or concerns for members and/or providers. Leverages a variety of communication channels to provide members and/or providers with timely, accurate, and personalized support on routine complaints and escalations.
- Assesses and researches routine member and/or provider inquiries, requests and/or concerns to determines causes, and initiates corrective actions to other service or technical departments for follow up as needed
- Mitigates and prevents complaints from being escalated to resolve in initial contact
- Serves as the front-line resolution advocate on various member and/or provider inquiries, requests, or concerns
- Provides support on various member or provider issues to ensure customers receive high-quality service
- Maintains performance and quality standards based on established contact center metrics
- Provides customer service in a high pace contact center environment over the phone, via live chats and emails
- Documents all member or provider information and communications for quality and performance tracking through the Customer Relationship Management (CRM) applications
- Remains up-to-date and adheres to quality standards, regulations, and all other policies to ensure quality, consistency, and compliance
- Provides expertise in resolving multiple inquiries, requests and/or concern across all areas of responsibilities
- Performs other duties as assigned
- Complies with all policies and standards
Education/Experience: Requires a High School diploma or GED.
Requires 1 – 2 years of related experience. May require vocational or technical education in addition to prior work experience.
Vocation or technical education may include additional on-the-job training or continuous learning education.
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