Call Center Rep I (remote)


The Call Center Representative (remote), Level 1, works as part of a team to answer calls from MedCost customers and provide resolution to inquiries related to healthcare insurance claims, eligibility, and other benefit plans administered by MedCost Benefit Solutions (MBS). Job seekers must have the ability to ask probing questions & diffuse tense situations. Employees must ensure that the quality of customer service provided to MedCost customers meets or exceeds the highest standards for the industry. This includes measurements of accuracy of information provided, consistency in documentation of each request, and use of appropriate inquiry codes.
Position Responsibilities:
  • Answer calls from MedCost customers for benefit questions and support, and provide resolutions as applicable for the levels defined for an entry level call center representative, or escalate requests as appropriate.
  • Identify Customer needs, clarify information, research every issue & provide solutions.
  • Complete a clearly written, detailed, accurate documentation of all conversations in MBS call center database.
  • As necessary, determine the need for escalation the appropriate referral channels and send request for additional action steps.
  • Make necessary outbound calls to correct issues or facilitate resolution for customers.
  • Stay abreast of resource information to ensure appropriate information is being provided. This includes, but is not limited to training manual, plan documents, on-line references & claims system.
  • Coordinate resolution of open issues from incoming calls assigned either through management of open issues log, or through call backs requested from voice mail.
  • Participate in staff meetings.
  • Effective queue management based on defined adherence goals, and/or staffing issues necessitating awareness.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Position Qualifications:
  • HS Diploma or equivalent required
  • Typing skills of at least 35 words per minute
  • 1-2 years call center or customer service experience focused on customer complaints
  • Knowledge and/or experience with medical terminology
  • Knowledge of the health care industry, call center queue environment, and claims payment processes
  Skills, Knowledge and Abilities
  • Excellent oral and written communication skills
  • Ability to ask probing questions & diffuse tense situations.
  • Exceptional customer service, and interpersonal skills
  • Effective problem-solving and influencing skills
  • Strong organizational, self-motivation, and decision-making skills
  • Proficiency using Microsoft programs (Word, Excel, PowerPoint)
  • Ability to manage multiple priorities in a fast-paced environment
  • Ability to work independently and collaboratively, as needed

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