Customer Service Representative (Temporary)

Convey Health Solutions is a fast-growing healthcare organization seeking a Temporary Customer Service Representative. The role involves transforming customer service into customer care by assisting beneficiaries with account updates, plan information, and resolving issues.

Responsibilities:

• Update account information such as billing options and changes of address or phone numbers
• Research premium billing discrepancies and prescription claims processed
• Educate beneficiaries on how the plan works, including benefits, cost sharing and levels of coverage
• Submit mail requests for beneficiaries such as ID cards and formularies
• Look up medicines on the formulary to verify if they are covered, the tier and copay level, and if a drug is not covered, provide an explanation as to why
• Displays positive demeanor, technical accuracy and conformity to company policies
• Understands CMS Guidance and ensures applicable exhibits are being mailed per CMS Guidance
• Ensure HIPAA regulations are maintained within the immediate environment
• Responsible for concise and detailed notations as it pertains to member records
• Handles outbound calls for purposes of validating information
• Handles inbound calls by assisting members with a high level of accuracy and efficiency
• Escalates any member issues to management as necessary
• Responsible for maintaining a high level of call quality as set by client standards, which includes a 95% quality score and answering 80-85% of calls within 30 sec or less
• Communicate with coworkers, management and customers in a courteous/professional manner
• Conform with and abide by all regulations, policies, work procedures and instructions
• Respond promptly when returning telephone calls and replying to correspondence
• Act and behave in a professional manner to reflect a positive image of the company

Requirements:

• Highschool Diploma is required
• Minimum 2 years working in a fast-paced high volume call center environment
• Strong desire to help people
• Strong customer care skills
• Attention to detail
• Very organized
• Associate Degree preferable
• Healthcare experience is a plus
• Good oral and written communication skills
• Good computer skills are required
• High school or equivalent (Preferred)
• Call center: 2 years (Preferred)
• Spanish (Preferred)