Customer Service Representative I

Job Title: Customer Service Representative 1

Duration: 31 weeks (Temp to Hire)

Location: Franklin TN 37067

Responsibilities:

· Handles customer service inquiries and problems via telephone, internet or written correspondence.

· Customer inquiries are of basic and routine nature.

· Our call center is open from 7 am to 8 pm Central Time. They could have an eight hour shift that falls within our business hours.

· Answers questions and resolves issues based on phone calls/letters from members, providers, and brokers.

· Triages resulting rework to appropriate staff.

· Documents and tracks contacts with members, providers and brokers.

· Explains member's policy benefits and coordination with Medicare

· Handle complaints (member/provider), via relevant recording/reporting system

· Ensures compliance with requirements of regional compliance authority/Medicare

· Determines applicable coverage provisions and verifies member plan eligibility

· Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible.

· Performs financial data analysis as necessary.

· Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received

· Adheres to international privacy policies, practices and procedures

Requirements:

· CSR must be able to read from a script.

· CSR must be able to type 30-35 WPM.

· CSR's should have at least a year of Medicaid/ Medicare experience.

· CSR must have Call Center/ Contact Center background

· Typing test/computer skills testing REQUIRED

· Family Summary/Mission To increase member satisfaction, retention, and growth by efficiently delivering competitive services to members and providers through a fully-integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes.

· Position Summary/Mission Handles customer service inquiries and problems via telephone, internet or written correspondence.

· Customer inquiries are of basic and routine nature.

If you are not interested in looking at new opportunities at this time I fully understand. I would in that case be appreciative of any referrals you could provide from your network of friends and colleagues in the industry. We do offer a referral bonus that I’d be happy to extend to you if they turn out to be a great fit for my client.

Kind Regards

Sumit Agarwal

732-902-2125