Customer Service Rep

DESCRIPTION / RESPONSIBILITIES : Job Summary Provides outstanding customer service related to Veteran care through the Community Care Network (CCN) in a fast-paced contact center. Responds to inbound calls and chat messages regarding authorizations for medical and behavioral health care, provider status and availability, or claims payment and status. Accurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and / or appropriate call escalation protocols. May make outbound calls to schedule appointments based on Veteran or VA request. Resolves administrative eligibility discrepancies through account research and review.Education and Experience Required :

• High School diploma or GED
• One year experience in a customer service role with performance metrics
• Experience using Microsoft Office products and the InternetPreferred :
• Healthcare industry experience to include knowledge of health services
• Contact center experience to include call center chat messaging
• Military experience focusing on service deliveryKey Responsibilities
• Manages multiple task lists in accordance with directed timelines. Meets call volume, chat volume, schedule adherence, quality, Veteran appointment, and other production standards.
• Initiates and receives phone calls, chat messages, and emails from VA medical center staff and providers to answer claims, eligibility, benefit, and program questions. In select markets, facilitates appointment scheduling of Veterans through outbound solicitation to providers. Records preferences and tracks Veteran questions thoroughly in the TriWest's Customer Relationship Management systems and Portal, as well as VA's HSRM systems.
• Consistently displays professional and courteous service skills to internal and external customers.
• Accurately resolves VA and provider inquiries with a focus on first call resolution.
• Protects the privacy of health information of patients when using or disclosing Protected Health Information (PHI).
• Takes appropriate measures to comply with HIPAA regulations to protect privacy of customers' health information.
• Documents all communications involving Veteran and provider contacts. Uses critical thinking in problem solving and follows established processes to assure quality program compliance.
• Consistently meets department productivity and performance metrics to include regular and consistent attendance.
• Participates in cross training, employee development, and flexible assignments to ensure business needs are met.Competencies Commitment to Task : Ability to conform to established policies and procedures; exhibit high motivation.Communication / People Skills : Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.Computer Literacy : Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.Coping / Flexibility : Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.Empathy / Customer Service : Customer-focused behavior; helping approach, including listening skills, patience, respect, and empathy for another's position.Information Management : Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.High Intensity Environment : Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.Organizational Skills : Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.Team-Building / Team Player : Influence the actions and opinions of others in a positive direction and bui d group commitment.Technical Skills : Proficient data entry skills; ability to meet daily call and chat requirements.Working Conditions
• Ability to cover any work shift
• Ability to work overtime, if needed
• Works within a standard office environment, with no travel
• Extensive computer work with prolonged sitting and wearing of headset
• Average salary for this role is around $48,048 depending on experience.Equal Employment OpportunityTriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.

Salary : $48,048