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Customer Service Representative $22

NationsBenefits

Customer Service Representative $22

Costa Mesa, CA
Full Time
Paid
  • Responsibilities

    Grow and lead among an award-winning and extraordinary organization that's dedicated to providing premier service and delighting members, 24/7/365. It all begins with how we care about the people we serve. Since 2015, our mission has guided our principles towards delivering solutions for a rapidly changing industry. Compassionate Care is at the center of all we do, and it unites us to foster an environment where everyone is empowered, inspired, and equipped for success.

    We make a difference in the lives of millions; that's something we can be proud of.

    Compensation for all positions is competitively higher than the current marketplace. Simply put - we pay more. We also offer a competitive benefits program, designed to support employees and their families across all dimensions of health including medical, dental, vision, life, disability, 401(k) and paid holidays/time off for eligible employees. You can earn even more through referral bonuses. Achieve your potential and grow your career at NationsBenefits.com/Careers.

    WHAT WE NEED:

    Member Services Call Center Representatives who will work closely with other team members to provide outstanding service to our customers by answering questions, gathering information, handling complaints, and troubleshooting problems on our client's behalf. The member services call center representative applies knowledge of business, products, members, and operations to fulfill member service requests and inquiries accurately and effectively.  They will listen to callers to understand the reason for their call, address all questions, provide an accurate and efficient response, and follow the workflow for their designated role.

    WHAT YOU'LL DO:

    • Completing inbound/outbound calls to members to learn about and address their needs or the needs of the clients we serve
    • Responding efficiently and accurately to callers
    • Research and resolve inquiries from internal /external customers including Enrollment, eligibility, ID cards, clinic changes, demographic changes, benefit coverage, claims, payments, member reimbursement, and demonstrated knowledge of CAG policies, procedures, and regulations. Utilize appropriate resources to respond to member inquiries
    • Answer, resolve, track and document telephone calls from members and providers in a timely and professional manner. Interpret member eligibility and coverage through thorough knowledge of the client products, policies, and procedures
    • Following the workflows and appropriate data capture in appropriate systems
    • Ensuring that callers feel supported and valued
    • Engaging in active listening with callers, confirming or clarifying information and diffusing angry clients, as needed
    • Utilizing software, databases, scripts, and tools appropriately
    • Meet or exceed call center metrics while providing excellent consistent customer service
    • Complete training and other learning opportunities to expand knowledge of company and position
    • Ability to remain confidential with all proprietary information
    • Adherence to all NationsBenefits, HIPAA, and MCO / Medicare guidelines
    • Performs additional duties as assigned by Management based business demands
    • Ability to work independently and capable of exercising excellent judgment to resolve Member related issues that arise
    • Ability to work a flexible schedule based on operational demands (day, night, weekends, holidays)

    WHAT WE ARE LOOKING FOR:

    • Exceptional customer service, active listening, and verbal and written communication skills, professional phone voice
    • Understanding of health insurance products, services, and policies is a plus
    • Proficiency with computers, especially with CRM software, and strong typing skills
    • Ability to ask prying questions and diffuse tense situations
    • Strong time management and decision-making skills
    • Adaptability and accountability

    WHAT YOU WILL NEED:

    • High school diploma or equivalent.  College degree is a plus.
    • Minimum 1 year customer service experience required
    • 1+ years call center experience preferred; healthcare industry is a plus.
    • Fluency in two or more languages is a plus

    NATIONSBENEFITS IS AN EQUAL OPPORTUNITY EMPLOYER.