What are the responsibilities and job description for the Customer Service Specialist position at Focus Care, Inc.?
Overview
Focus Care, Inc. is a national company located just north of Boston, Massachusetts. We specialize in Medicare and Medicaid health risk assessments, care management and other nursing support services. Our Member Service Specialist (MSS) operate in a call center environment, dedicated to timely, thorough, and compassionate member care. In this structured inbound/outbound high call center environment, MSS are responsible for scheduling, data entry, provider relations for all lines of business.
Responsibilities
- As a member of Focus Care, you will be responsible for contacting members of various Health Plan Providers by phone to offer, explain, and ultimately schedule them for either Provider or at – Home Healthcare Based Appointments.
- Adjusting and Resetting appointment dates and times, as required
- Work diligently to meet department goals for productivity, quality, and overall success rate.
- Handle a high volume of outbound calls placed by our provided phone system, and fully explain the services offered to them.
- Handle a high volume of inbound calls to answer member questions as well as other customer service activities
- Return voicemail messages from members to schedule appointments as well as other customer service activities
- Follow approved scripting and talking guidelines when discussing healthcare-based appointments with members, ensure members understand and are comfortable with the information provided.
- Present a positive face to health plan members, and other members of the workforce.
- Leverage Focus Care Systems to maintain member information and appointment information accurately.
- Report member complaints and issues immediately through appropriate, company approved channels.
- Be responsible for the security and privacy of all protected health information that may be accessed during normal working hours.
- Be available, accessible, and accountable to work during established working hours. Follow support processes, comply with organizational structure and security standards, training, performance management routines, and remote monitoring policies.
Requirements
- A desire to work in a fast paced, efficient, and results oriented call center environment
- A strong work ethic and autonomy to stay on task, highly motivated to achieve productivity goals.
- Good communication skills, friendly and conversational with members.
- High level of discretion, ability to maintain confidentiality
- A willingness to comply with a fixed daily schedule, including start, break, lunch, and end times
- An ability to take direction and receive critical feedback
- A shown skillset with regards to Data Entry and Integrity of Data, proficiency with the MS Office Suite of applications.
- Ability to type on average 60 words per minute.
- Must display aptitude for critical thinking, as well as problem-solving acumen.
- Experience with mapping systems preferred
- Healthcare/sales experience preferred
- Previous customer service/ contact center experience preferred
- Must have verified internet service with a minimum download speed of 10 MBPS.
About Focus Care Inc.
Focus Care, Inc is a Boston-based, privately-owned national healthcare services company that has been in business for more than 22 years. We identify and document high risk conditions of Medicare and Medicaid members to improve health outcomes and achieve accelerated health plan reimbursement through risk adjustment, network development and care management. Our vast national provider network includes all levels of practitioners (LPN/LVN, RN, NP, PA, and MD). Our leadership team and clinical staff have demonstrated success in working with all health care programs, including Medicaid, Medicare, PACE, and Colorado Transitions. Nearly 10 years ago, Focus Care transitioned its hospital nurse staffing business to a broader offering with emphasis on Medicare Advantage health risk evaluation and revenue maximization services. Today, our U.S call center and member engagement solutions reach health plan members and patients to connect and guide them on a path of better health and wellness.
