● Answer a high volume of calls, chats, or emails from plan participants regarding various aspects of
their benefit plans
● Proactive identification, elevation and execution of actions needed to resolve issues as they arise
● Provide Tier One escalation support
● Help guide and educate customers about the fundamentals and benefits of consumer-driven health
care topics to select the best benefit plan options, maximize the value of their health plan benefits and
choose a quality care provider
● Proactively recommend solutions and set appropriate expectations for participants
● Provide accurate information to plan participants and internal business partners
● Strive for first call resolution with all participant interactions including complaints and escalations
● Display professionalism and be empathetic with participants during difficult times
● Maintain compliance on all HIPAA guidelines and regulations without exception
● Document all activities for quality and metrics reporting through the Customer Relationship
Management (CRM) application
● Complete other duties and special projects as assigned by management
KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:
● Proven excellence in customer service and professional writing
● Ability to work well independently and within a team environment, with strong ability to multitask
● Demonstrated experience solving problems and asking probative, detailed questions to facilitate
● Anticipate, empathize and address the needs of the customer
● Be a keen problem-solver that can think on his/her feet
● Be a self-starter who is comfortable taking the initiative as well as owning issues from start to finish
-1 to 4 years experience of multi-channel service experience, including the support of customer chats and emails in a contact center environment.
-Associate’s degree or 4 or more years of professional experience in a related field is required.
-Previous healthcare, benefits administration, or insurance industry experience is preferred, but not required.
-Bilingual a PLUS.