Our Customer Care Ambassadors are the first line of support responsible for providing accurate and thorough information via telephone to current and prospective members, providers, and internal customers for our Senior Care Options line of business. The Ambassador is also responsible for resolution of customer inquiries and acts as a member advocate in order to build member loyalty and extend member retention. In addition to providing detailed information on a wide range of topics, the Customer Care Ambassador is responsible for resolution of complex member inquiries. S/he is expected to take complete responsibility for every interaction with members, providers and internal customers by providing outstanding service to contribute to corporate service goals and objectives.
KEY FUNCTIONS/RESPONSIBILITIES:
- Resolves customer inquiries and problems through effective interaction with both internal and external staff‚ particularly in the areas of Marketing, Enrollment‚ Provider Relations‚ Sales, Care Management and Customer Care Center leadership
- Responds to a high volume of incoming calls (call length can vary widely from 5 minutes to 45 minutes or more)
- Outreaches to all new Senior Care Options Program enrollees within designated time periods from start date of enrollment via the telephone; introduces self and ensures enrollee is orientated to the Senior Care Options Program and benefits
- Maintains knowledge of the Plan contracts and effectively interprets information related to benefits
- Employs strong interpersonal skills in order to handle difficult calls courteously and professionally
Works with peers to solve problems and promotes teamwork
- Coordinates and schedules timely meetings between prospective members and the BMCHP Sales team; Works closely with Sales to ensure timely response to prospective member requests
- Identifies and communicates trends that are indicative of enterprise service issues; communicates with Public Partnerships, Compliance and the Legal departments on compliance-related issues as needed
- Communicates verbally and in writing with providers to educate them on balance billing practices and ensure members are billed (or not billed) in accordance with applicable contractual and regulatory guidelines
- Coordinates and schedules timely assessments with the Care Management team
- Performs other duties as assigned
QUALIFICATIONS:
EDUCATION:
- High school diploma or equivalent required
- 1 year of Customer Service experience
EXPERIENCE:
- 1 – 3 years of related experience in a service position is required
- Successful performance of duties at previous level(s) of Customer Care positions
COMPETENCIES, SKILLS, AND ATTRIBUTES:
- Excellent verbal and written communication skills required
- Proven and outstanding customer service skills, and organizational skills with the ability to prioritize a high volume of adjustment requests, multi-task and prioritize work
- Demonstrated ability to make reasonable and sound business decisions based on established BMCHP standards and guidelines
- Ability to work effectively in a team environment
- A working knowledge of Microsoft Office products
- Bilingual in Spanish, Portuguese, Haitian Creole or other language is highly desirable
*Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.
Required Skills
Required Experience