Customer Service Support Specialist (***)

Moda Health is a company committed to quality healthcare and community support. They are seeking a Customer Service Support Specialist to provide technical support and customer service to internal and external clients across various platforms. The role involves troubleshooting issues, responding to customer inquiries, and maintaining records of interactions to ensure customer satisfaction.

Responsibilities:

• Responsible for interpreting needs/concerns, determining best course of action, troubleshoot, and identify system issues and solutions. Guide users through features and functionalities
• Respond to customer queries in a timely and accurate way, via phone, email, chat or social media
• Quickly identify problems, form solutions, and execute step-by-step troubleshooting procedures
• Support customers across different platforms; phone, email, chat or social media and ability to trouble shoot multiple devices (desktop pc, tablet, phones, browsers, hardware, OS)
• Resolve issues efficiently from start to finish, set appropriate expectations and follow through; and/or escalate support tickets to leadership when escalation is required
• Analyzing and reporting system issues and trends in a timely manner. Provide customer feedback received to leadership
• Develop access to registrants’ passwords and log-in data so when questions are received a prompt answer can be provided
• Ability to repeatedly analyze situations and communicate effectively in a fast paced environment that includes dealing with angry people
• Exercise judgment, initiative, and discretion in confidential and sensitive manners
• Consistently follow the correct process and procedure with each line of business and contact method being used
• Maintain forms necessary for new external provider and employer users
• Responsible for handling all requests received for Certificate of Coverage and CCC letters
• Responds to Benefit Tracker, MyModa, EBT and External Secure email user questions (via telephone, email, or correspondence)
• Monitor customer complaints on social media and reach out to provide assistance
• Respond to email inquiries received from multiple mailboxes across all lines of business: MyModa, Medical, Dental, Pharmacy, EBT and Individual Membership Accounting, within established turnaround times
• Open and Submit service tickets for possible Benefit Tracker, eBill and MyModa programming changes, system issues and trending topics (following established reporting policy)
• Review, update and become familiar with new and revised benefit information or claim processing procedures
• Contact providers, group administrators and agents when necessary to answer questions and obtain or provide information
• Support and assist Medical, Dental, Pharmacy and Individual Membership administrator questions
• Maintain detailed records of daily interactions with customers, reported issues, and completed solutions along with any further actions required of customer service or Moda
• Communicate clearly and effectively with end users, colleagues, and management to quickly resolve issues and ensure customer satisfaction
• Other duties as assigned

Requirements:

• High school diploma or equivalent
• 6-12 months experience as a Customer Service Rep Level II, consistently exceeding level of performance or equivalent work experience or equivalent work experience
• 10 key proficiency of 135 spm net on a computer numeric keypad
• Typing ability of 25 wpm net
• Computer proficiency with multiple systems, browsers, Moda software (Microsoft Office applications, Facets, Content Manager, Excel, EBT, online chat) and updates
• Prior experience or basic understanding of claims processing, membership accounting, medical/dental/pharmacy plan benefits and/or other related experience handling Customer Service escalations, Technical Support or Online Chat
• Strong time management, planning and organization skills with ability to prioritized and manage changing priorities
• Ability to handle multiple tasks simultaneously and adapt to change
• Ability to work well under pressure in a complex and rapidly changing environment
• Ability to anticipate, identify, analyze and resolve conflict and problems
• Ability to listen and understand information verbally and in writing
• Well-developed verbal and written communication skills with the ability to actively listen, interact professionally, patiently and courteously with clients on the phone, in person, through email, social media or online chat
• Strong analytical and critical thinking, problem solving, decision-making skills, with attention to detail
• Maintain confidentiality and project professional business presence and appearance
• Ability to comply with company rules and policies and maintain attendance above company standards
• Able to embrace process improvements and works well in a team oriented environment
• Demonstrated ability to handle difficult calls and benefit issues with little assistance and provide accurate information in a fast paced environment
• Experience working in a collaborative and fast-paced team environment
• Demonstrated real time problem-solving skills and ability to prioritize multiple tasks based on urgency and importance
• Help customers troubleshoot issues they encounter and provide actionable tips to resolve
• Demonstrated outstanding attention to detail, ownership, and follow-through
• Consistent record of achieving individual and team metrics
• Excellent professional written & oral communication skills
• Passion for technology and willingness to learn new skills
• Ability to navigate multiple computer programs in a fast pace multi-tasking environment
• Empathy/compassion for working with senior, disabled, low income populations
• Ability to work extra hours and participate in overtime as needed
• Ability to work with multiple Pharmacy, Dental and Medical (Individual, Specialized, Medical Intake, EOCCO) applications and contacts types at the same time