[Hiring] Customer Service Representative @FRINGE BENEFIT GROUP

Role Description

The Customer Service Representative will be responsible for all forms of member or participant level contact from members, providers, and occasionally employer and brokers. The primary contact will be inbound calls. Other forms of contact may include mail, email, fax, chat, and outbound calls. Primary call types include benefits and eligibility, enrollment, claims, and retirement account questions.

Qualifications

• Requires a minimum of a high school diploma or its equivalent
• Experience in healthcare / medical benefits or claim inquiries / Retirement / Insurance and Customer Service
• Proven communication and customer service skills
• Ability to adapt communication style based on the caller's needs
• Responds well in a stressful, dynamic environment

Requirements

• Actively listen to caller questions and needs to provide quality answers to their understanding
• Respond well in stressful, dynamic calls to promote a resolution to an issue
• Answer inquiries and promote the organization's products and services
• Research and investigate complaints to ensure compliance and procedural adherence
• Develop, nurture, and sustain professional relationships with internal and external business partners by communicating well
• Observe protocol and utilize systems to deliver service consistent with department goals
• Take pride in our work as we deliver service customized to our member’s needs
• Contribute to the feedback process by sharing member and provider feedback with management
• Generate and utilize system reports to review, analyze and optimize key performance metrics
• Participate/support new business growth and retention as an agent providing a quality service experience
• Participate in team functions with a customer-centered focus
• Provide feedback to leadership to assess and keep abreast of any escalating service issues
• Execute effective and timely resolutions while advocating for the interest of the member/client
• Know accounts, products, scripts, and processes to anticipate needs and provide direction
• Listen for the needs of the member and communicate actionable steps
• Own tone and attitude while meeting deadlines and practicing good office etiquette
• Highly motivated self-starter with the ability to manage multiple priorities
• Ability to work as a team player with a positive approach to adversity
• Critical thinking skills to identify deficiencies in a dynamic environment
• Spends up to 100% of the time on phones
• Answer questions and handle problem resolution on benefit, provider or claim issues
• Follow up with members and providers as necessary
• Process benefit coverage changes and send out supporting documentation
• Proactively manage expectations and set realistic expectations for the caller
• Read required disclosures to enrollees
• Follow privacy and HIPAA guidelines as trained
• Work schedule as agreed to and assigned
• Adhere to attendance guidelines including tardiness and breaks
• Maintain Call Quality standards as assigned
• Navigates system with proficiency
• Possesses necessary computer skills to perform required functions
• Use a tone and educational style to promote understanding
• Collect detailed information and documents per protocol

Benefits

• Provide a professional work-from-home environment with high-speed internet
• Business Travel: Possibly one to two times per year for company-wide meetings and training
• Job Type: Full-time