Job Details
Location Orange Job Title Customer Service Representative I Description Purpose of Position: Handles calls from customers to resolve, educate, follow-up and respond to questions regarding Choice Builders plan administration and procedures for groups, members, brokers and general agencies.
Essential Functions: Understanding of company policies and procedures as they apply to Choice Builder plans.
Answers questions via telephone from employers regarding new hires, billing, rates, supplies, administrative procedures, etc.
Educates, via telephone or email, employees/dependents regarding ID cards, administrative procedures, dependent coverage, address changes, etc.
Follows-up on calls from brokers regarding problems that their groups are experiencing with providers.
Ability to interact with brokers, General Agents and sales representatives on a daily basis and must be able to answer questions regarding Choice Builder process.
Verifies enrollments and resolves claim issues.
Document calls in call tracking system and Opportunity.
Ability to work in a paperless environment with the Doc Link system.
Departmental standard requires each Customer Service Representative to provide Service of Unequalled Excellence to all callers.
Answer at least 100% of the daily call volume average.
Provide clear and explicit documentation while maintaining percentage at a level of 90% or higher daily.
Make busy time of 30 minutes or less per day.
Meet department standards for quality and quantity of work.
Meet department and team standards for turnaround times.
Adhere to all HIPAA/PHI (Personal Health Information) guidelines.
Other duties as assigned by Choice Builder management team.
Onsite regular attended and punctuality are essential functions of the job Requirements Knowledge, Skills & Abilities Required:
Must have excellent verbal and written communication skills, especially under pressure.
Must be computer literate in Microsoft Word, Excel and Outlook.
Accurate data entry skills a must. Computer literate (Windows) and Word Processing Skills (MSWord). Typing at 55 WPM or more.
Knowledge of the health insurance industry and customer service experience preferred.
Must be able to work in a fast-paced environment where deadlines are a priority and handling multiple assignments simultaneously.
Problem Solving Skills is a must.
Must have a proficient knowledge of the English language. Proficient knowledge of the Spanish language required.
Educational Requirements:
High school diploma or equivalent.
Physical Requirements:
This position is required to sit 90% of the time. Must be able to walk, utilize stairs, bend, stoop and lift up to 30lbs. Close vision required.
Must be able to perform data entry to computer system for up to 6 or 7 hours daily.
Utilize fingers, hands and arms to feel and manipulate.
Working environment is stable and noise level is moderate.
Possible Overtime Required.