This position will act as a liaison by handling inquiries, complaints, concerns, education and assisting those customers in utilizing the resources and services of Hometown Health. This position identifies potential or existing service related or operational issues for the purpose of increasing customer retention and satisfaction.
Nature and Scope:
Under the general direction of the Customer Services Manager and Customer Service Lead/Trainers, this position is responsible for keeping appropriate staff informed of customer opinions and viewpoints as well as needs.
The incumbent functions as a representative of Hometown Health to provide appropriate responses to its customers regarding Plan benefits to include, but not limited to eligibility, provider network, referral and authorization process, claims payment, as well as policies and procedures. They will do so in a consistently service-oriented manner.
Exercises appropriate call back procedures on inquiries, complaints and e-mails needing review and additional follow up prior to providing responses.
Provides support to the Lead/Trainer positions. In the event the Lead/Trainer or the Manager is absent, this individual would have the ability to provide support and guidance to the Department.
This position does not provide patient care.
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
Minimum Qualifications: Requirements - Required and/or Preferred
Must have working-level knowledge of the English language, including reading, writing and speaking English. High school diploma is preferred and preference will be given to applicants who have earned a degree from an accredited college.
Requires two to three years of experience in a position involving public relations or customer service. Two years experience in a position directly or indirectly associated with group health benefits preferred. Ability to speak Spanish preferred.
Computer / Typing:
Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.