Responsibilities includes silent monitoring of incoming customer telephone calls, outbound customer telephone calls, evaluating completed customer correspondence, the walk-in unit, and weekly in box audits. Also responsible for the transition of new customer service representatives from formal classroom training to servicing customers in an independent manner. This includes, but is not limited to, training interdepartmental policies and procedures, reinforcing benefits and applicable systems and workflow. Assists the supervisor with coordinating daily work assignments, collecting data, implementing member educational programs and monitoring the member’s level of satisfaction with the Plan. Works closely with all management staff in the department to develop countermeasures such as focused re-training, developing new workflows, enhancement of the quality monitoring program and revisions of policies/procedures.
- Associates Degree preferred.
- Minimum of 2 years experience in the health insurance industry required; 1 year in a call center environment required.
- Minimum of 1 year as a customer service representative OR conducting quality assurance monitoring or training in insurance organization or health related industry required; experience in developing and implementing quality programs desired.
- Strong working knowledge of Microsoft Word required; Excel and Access preferred.
- Demonstrated ability to coordinate the workflow of the service representatives and train staff in contract interpretation and member services required.
Salary Grade: 14
CDPHP - 23 months ago