Customer Service Rep (Premier)

Job Description

REQUIREMENTS

Minimum High School diploma or equivalent

• Two years of college education preferred.

Experience:

• 2-3 years proven work experience with customer contact preferred**
• Experience in the hospitality, healthcare, or pharmaceutical industry
• Exceptional customer service, problem-solving skills.
• Bilingual a plus
• Strong communication skills
• Demonstrated strong interpersonal skills
• With minimal supervision, demonstrates the ability to research and analyze information from various systems, make responsible decisions, and demonstrate customer-focused professionalism at all times.

RESPONSIBILITIES

• Attains and keeps current with the knowledge and skills required to provide information, service, and assistance in response to all inquiries.
• Available as assigned to accept calls in a professional and courteous manner.
• Determines the nature of the call and takes all possible action, including research, completing forms, or any follow-up, to expeditiously ensure the provision of accurate information, service, and assistance upon first contact.
• Acquire knowledge of all claims systems applications and member service systems.
• Prepares and forwards appropriate requests to operating areas to accomplish action required as a result of the inquiry.
• Checks internal system inboxes to ensure completion and follow-up action. Obtains required information and makes a callback when necessary to complete action on inquiries.
• Meets quality performance standards and works within established time frames.
• Acknowledges each piece of mail and responds to written inquiries either by telephone or letter as required in a professional manner.
• Advises the Supervisor when any of the above accountabilities cannot be performed because of matters beyond the control of the Representatives, such as system, procedural, or administrative errors that indicate a trend.
• Ability to ask effective probing questions and deescalate challenging member inquiries and concerns.
• Supports the area in the ongoing use of TQM principles in a continuous quality improvement process.
• Performs other duties as assigned.

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