Customer Service Representative II

Summary

Reporting to the Staffing Manager, the Customer Service Representative II is responsible for promptly and professionally responding to inquiries.  The Customer Service Representative will demonstrate excellent verbal and written communication skills. Strong human relations and organizational skills.  Ability to handle high stress situations. Good judgment skills. Strong customer service skills. Ability to learn and operate multiple computer systems effectively and efficiently

Position Type: Full Time  
Days: Monday-Friday 
Hours: 7am-4:05pm
Pay: $17-$18 based on physical  location and the WDR 
Travel: up to 10% 
Location: STL Staffing Office/Alton Admin Offices/ Remote Location 

• Responds to telephone inquiries from providers or representatives.
• Establish and maintain rapport with contacts and present a favorable corporate image. 
• Educate and respond to customers on coverage, claim submission, and use of self-service offerings, billing and coverage issues not answered by the integrated voice response. Assist and educate providers on Medicare regulations. 
• Research Provider Inquiry electronic work processes and reference manuals throughout the process of making determinations to provide accurate responses in inquires and follow up. 
• Log all inquires and document/update clearly and accurately in the inquiry tracking systems. 
• Refer unusual or complex inquiries to Senior Customer Service Representatives. 
• Meet compliance requirements of Federal Privacy Act, Freedom of Information, Desk Disclosure Reference and conflict of interest and confidentiality. 
• Identify and refer potential fraudulent providers or beneficiaries to Complaint Screening. 
• Refer misdirected phone calls and unusual claims to appropriate areas. 
• Assist the department in meeting CMS performance metrics and quality and quantity standards. 
• Provide technical assistance by identifying and reporting system problems, and testing new enhancements. 
• Deal tactfully with internal and external customers and respond professionally. Provides feedback to management regarding customer issues, questions and needs. 
• Maintain records on complaints and other customer comments and makes recommendations for changes. Follows through on complaints until they are resolved or reports to management as needed
• Ensures an outstanding customer experience and provide exceptional customer service Identify appropriate information and communicate clearly and professional to promote satisfaction. 

• Education: High School Diploma or GED required  
• Experience: Us. Residency for 3 of the last 5 years required for this position
• Proficient with Microsoft Word, Excel and Outlook 
• Background checks: must pass criminal background check, various state and federal registry checks, pass DCFS abuse and neglect tracking system check and OIG, SAM, and OFAC searches.
  
   

Salary : $17 - $18