Handles bilingual (spanish, french/creole) customer service inquiries and problems via telephone, internet or written correspondence. Calls are typically non-routine and may require deviation from standard screens, scripts, and procedures. Act as a subject matter expert by providing training, coaching, or responding to complex issues. May analyze and adjudicate claims.
WE ARE SCHEDULING INTERVIEWING NOW; SLOTS ARE FILLING QUICKLY! IF INTERESTED APPLY NOW.
****Bilingual English (Spanish, French, Creole) Required
****Recent Health insurance (Medicare, Medicaid, HMO’s, PPO’s) customer service experience required
****Call center experience required
Answers questions and resolves issues as a “single-point-of-contact” based on phone calls, letters, and internet from brokers, marketing plan sponsors, PSS/ISO, members and providers. Activities may include providing claim status information, benefit coverage interpretations, and explaining plan eligibility.
Processes claim referrals, new claim hand-offs, nurse reviews, and member/provider complaints. Escalates issues as appropriate through the target system for grievances and appeals.
Initiates out-reach/welcome calls to ensure constituents expectations are met or exceeded. Through in-depth analysis, identifies complaint trends and any emerging customer service issues and works to develop solutions to address potential problems
Educates customers on various elements of benefit plan information and available services created to enhance the overall customer service experience with the company (i.e., assistance with Navigator) * Partners with other departments to deliver client specific presentations. Coordinates efforts both internally and across departments to successfully resolve service issues and develop process improvements intended to enhance the overall delivery of service.
Serves as SME providing technical assistance when needed on call related issues, products, and/or system applications delivery matters.
Coaches, trains and assists in the development of call center staff. May participate and/or lead special projects/initiatives addressing service issues.
May provide technical or subject matter expertise concerning policies, procedures, and function-related applications/systems tools
Delivers internal quality reviews. Provides appropriate support in third party audits when required.
Documents and tracks all contacts, events, and outcomes with clients using appropriate systems and processes.
Salary: $16.50 /hour
Job Types: Full-time, Contract
Pay: $16.50 per hour
Benefits:
Health insurance
Schedule:
8 hour shift
Monday to Friday
Experience:
Health Insurance: 2 years (Required)
Medicare, Medicaid, HMO, PPO: 2 years (Required)
Health Plan/Managed Care: 2 years (Required)
Healthcare Customer Service: 2 years (Required)
High Volume Call Center: 2 years (Required)
Education:
High school or equivalent (Required)
Language:
Spanish or French/Creole (Required)
To apply for this job please visit us.nttdata.com.
