Customer Service Representative

AmeriHealth Caritas • United States, United States • 3w ago

Responsibilities:

Under the direct supervision of the operations supervisor, the customer service representative is responsible for responding to a diverse membership and their providers, as well as other customers, in a timely, professional, and courteous manner. This includes inbound and outbound member and/or provider phone calls or correspondence regarding benefits, eligibility, or customer issues. Makes outreach welcome calls to new members and conducts Health Risk Assessment Surveys as needed. Provides member education and assists members with PCP selection and assignments. Assists with access to care and wellness programs. Follows internal processes and procedures to ensure all activities are performed in accordance with departmental and company policies and procedures.

Demonstrate a passion for providing superior customer service to our customers and continually seek to understand the needs of those we serve.

Create accurate and timely member documentation concerning all inquiries taken in accordance with established protocols to ensure resolution is provided and presented in a clear and accurate manner.

Present and project a positive image of the company in and out of the office to fellow associates, members, providers, and the community by being courteous, helpful, energetic, respectful, and polite.

Strive to resolve an inquiry on first contact while ensuring that the inquiry has been addressed to the customer's satisfaction by using all resources efficiently and timely.

Provide feedback and/or solutions to the supervisor to ensure continuous process improvement and provide a better customer experience.

Creates and supports an environment that fosters teamwork, cooperation, respect, and diversity.

Maintain an awareness of all product knowledge information.

Able to respond positively to support change within the department and the company.

Willing to be flexible regarding job responsibilities and schedule, not limited to but including, overtime and holidays, as a result of contractual business requirements.

Routinely meet or exceed contact center key performance indicators.

Perform other duties as assigned.

Education/Experience:

High School diploma or GED required.

1 year prior customer service experience required.

Call center experience taking in-bound and/or out-bound calls preferred.

Prior experience in the healthcare or managed care industry preferred.

Excellent judgment and decision-making skills in dealing with complaints and sensitive requests required.

Ability to use PC applications in an MS Windows based required.

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to connect with you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

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