Customer Service Representative

Responsibilities

Under the direct supervision of the operations supervisor, the customer service representative is responsible for responding to a diverse membership and their providers, as well as other customers, in a timely, professional, and courteous manner. This includes inbound and outbound member and / or provider phone calls or correspondence regarding benefits, eligibility, or customer issues. Makes outreach welcome calls to new members and conducts Health Risk Assessment Surveys as needed. Provides member education and assists members with PCP selection and assignments. Assists with access to care and wellness programs. Follows internal processes and procedures to ensure all activities are performed in accordance with departmental and company policies and procedures.

• Demonstrate a passion for providing superior customer service to our customers and continually seek to understand the needs of those we serve.
• Create accurate and timely member documentation concerning all inquiries taken in accordance with established protocols to ensure resolution is provided and presented in a clear and accurate manner.
• Present and project a positive image of the company in and out of the office to fellow associates, members, providers, and the community by being courteous, helpful, energetic, respectful, and polite.
• Strive to resolve an inquiry on first contact while ensuring that the inquiry has been addressed to the customer’s satisfaction by using all resources efficiently and timely.
• Provide feedback and / or solutions to the supervisor to ensure continuous process improvement and provide a better customer experience.
• Creates and supports an environment that fosters teamwork, cooperation, respect, and diversity.
• Maintain an awareness of all product knowledge information.
• Able to respond positively to support change within the department and the company.
• Willing to be flexible regarding job responsibilities and schedule, not limited to but including, overtime and holidays, as a result of contractual business requirements.
• Routinely meet or exceed contact center key performance indicators.
• Perform other duties as assigned.

Education / Experience :

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

Generous paid time off and paid volunteer time off.

Employer-matched 401(k) and additional non-elective contributions, starting on day one.

Medical, dental, and vision plans — with coverage starting on day one.

Employee assistance programs, fitness reimbursements, nutrition counseling, and more.

Employer-paid life insurance, with opportunities to purchase additional coverage.

Employer-paid short-term disability coverage and long-term disability coverage.

Tuition assistance, including reduced tuition at certain schools.

Financial assistance with adoption, including paid time off.

Flexible spending and health savings accounts to pay for qualified expenses.

Discount programs on entertainment, travel, and more.