Call Center Representative

Job Type
Full-time
Description
Position Purpose:
The Customer Service Representative III works in a contact center environment to provide exceptional and professional customer service. The Customer Service Representative III will assist in providing support and leadership to entry and mid-level team members. The Customer Service Representative III is accountable for delivering high-quality professional customer service in accordance with the mission, core values, and purposes for the assigned client.
Position Responsibilities:

• Support inbound and outbound omnichannel campaigns (i.e. welcome calls, benefit updates, health risk screening, emails, chats, texts, telephony, worklist items).
• Influence members to take advantage of health plan benefits by educating members on enhanced services that are available, recommending preferred providers.
• Educate members Emergency Department utilization for non-emergent conditions and the impact to their benefits.
• Identify and overcome barriers in order for members to complete needed health screenings, obtain needed services, access to care through appointments, and make payments to secure enhanced benefits.
• Ensures that all customer interactions are handled in a professional and service-oriented manner.
• Review member profiles prior to outreach to identify areas of opportunity, which includes but is not limited to reviewing additional benefits available for members and identify opportunities for members to become eligible for additional benefits.
• Participate in continuous quality improvement initiatives to ensure department and company goals are met and exceeded.
• Analyze data and reports to ensure adjustments and changes yield anticipated results.
• Act as a secondary resource for the Member Services or Provider Services Call Centers. Assist with tracking and monitoring the workflow to ensure that all goals are being met.
• Call Center Representative investigate and resolve problems and document actions taken.
• Serve as the point of contact to support call escalations.
• Assist with training, coaching, and staff development.
• Serves as the back-up team lead.
• Back up to Project/Point of Contact.
• Explore customer concerns and problems to uncover opportunities for additional sales.
• Document all member issues, concerns, resolutions, and interaction outcomes in designated system(s) according to standard operating procedures.
• Call Center Representative meet and exceed department expectations & key performance indicators set by management.
• Ensures that all client reference materials are current and designed to assist with resolving member inquiries.
• Promote positive relationships with staff, client and customers.
• Other duties as assigned.

Requirements
Position Requirements/Abilities:

• Call Center Representative possesses highest level of Call Center skills and knowledge to handle the most complex issues that occur during the workday.
• High degree of Call Center competency (dialer, KPI, Call Flow)
• Previous experience with dialer, CRM,
• Works well in a team environment and as part of a team.
• Proven record of achieving/exceeding established goals
• Leadership skills
• Ability to mentor, coach and train
• Ability to conduct Q/A
• Extensive experience and proficiency with Microsoft Suite including (Excel, spreadsheet and database)
• Client engagement
• Demonstrates customer service orientation.
• Call Center Representative able to read, interpret, and use forms and other visual instructions in order to perform required work.
• Proactive in anticipating and alerting others to problems with projects or processes.
• High level of detail orientation and accuracy.
• Takes initiative and needs little supervision.
• Able to prioritize, organize tasks and time, and follow up. Performs responsibilities efficiently and timely.
• Exceptional team player.
• Ability to work independently under general policy and strategic guidance.
• Proven ability to meet tight deadlines

Education, Work Experience, Licensure:

• High school education or equivalent plus 6 plus years of customer service experience inbound/outbound a Call Center environment
• 3-5 years' experience in a high-pressure environment
• 2-4 years' experience sales experience in a contact center or other sales environment.
• Bilingual in Spanish and English preferred.

Supervisory Responsibilities:
This position does not have supervisory responsibilities.