Customer Service Representative

Revelations Counseling & Consulting is hiring a Customer Service Representative to support Veteran care through the Community Care Network. The role handles calls and chats about authorizations, provider availability, and claims, resolves administrative eligibility discrepancies, and may schedule appointments.

Responsibilities:

• Manages multiple tasks 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 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

Requirements:

• High School diploma or GED
• One year of experience in a customer service role with performance metrics
• Experience using Microsoft Office products and the Internet
• Proficient data entry skills: Ability to meet daily call and chat requirements
• Influence the actions and opinions of others in a positive direction and build group commitment
• Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented
• Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions
• Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow
• Customer-focused behavior; Helping approach, including listening skills, patience, respect, and empathy for another's position
• Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required
• Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications
• Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; Listen critically; Collaborate
• Ability to conform to established policies and procedures; exhibit high motivation
• Healthcare industry experience to include knowledge of health services and claims
• Contact center experience to include call center chat messaging
• Military experience focusing on service delivery