Client Services Assistant

Job Description:

• Handle all inbound customer contact received by telephone
• Troubleshoot both complex medical/technical and routine requests
• Place outbound and received inbound calls to customers in accordance with call log procedures and policies
• Receive, resolve and follow-up with the most complex customer.

Job Details:

• Handles customer inquiries received by telephone regarding the health plan services that the customer is entitled to which we are contracted to assist with.
• These will include but are not limited to the following types of services: In Home Wellness Assessment exams, DRE exams, DEXA exams, etc.
• Discuss the health plan approved services with the customers using established protocols
• Document reporting or call history in required format and maintain complete and accurate records
• Contact the customer to resolve routine matters related to the health plan approved services (such as a need for the Provider to reschedule an appointment)
• Report customer or provider concerns using established protocols
• Understands the importance of Quality Service and how it is measured
• Escalates issues as appropriate using established protocols
• Provide research and resolution on complex issues, including those that have been referred by PCC I and PCC II Be certified as a SME (Subject Matter Expert) in one area (i.e, DEXA, Mapping, Rebuttling, etc)
• Provides peer to peer coaching and mentoring to new hires, PCC I and PCC II
• Remains current on PCC I and PCC II tasks and processes
• Recognize quality service issues and provide feedback to appropriate personnel on opportunities for improvement
• Provide floor support for team
• Responsible for maximizing quality and efficiencies to meet department goals
• Leads by example in demonstrating “Everyday Excellence ” behaviors
• Maintains performance and quality standards as defined by the business.
• Maintain an availability % of 90% or greater, quality scores of 95% or greater, and making 100 calls a day
• Perform other duties as required to meet the customer requirements
• Medical background not needed- more of customer service/sales
• Sales background is positive- good negotiation skills helpful
• Great computer skills and customer service skills needed.
• BILINGUAL

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