Company name
Humana Inc.
Location
Albany, NY, United States
Employment Type
Full-Time
Industry
Customer Service, Call Center
Posted on
Jun 29, 2022
Profile
Description
The Consumer Service Operations Representative 3 is responsible for the daily activities across multiple service functions area, including but not limited to mobile touch point locations in the various markets. The Consumer Service Operations Representative 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment
Responsibilities
The Consumer Service Representative 3 will focus on membership retention of current and new members by providing local proactive 'high touch' outreach and enhanced member experience. This role includes functions relative to benefits, enrollment and eligibility, member support, claims interpretation and processing, agent support, onboarding, local agency outreach, billing issues, payments, provider questions and call center operations. The Representative will regularly exercise discretion and judgment in prioritizing requests, interpreting and adapting procedures, processes and techniques.
The Consumer Service Representative 3 will work alongside a Sales Manager in a specific market by making outbound calls and proactively managing potential member dissatisfaction. The associate will focus on membership retention of current and new members by providing local proactive customer service as it relates to members plan i.e. benefits, enrollment, eligibility, billing issues, payments, provider questions. Associate will be responsible for making outbound calls as well as having the flexibility to work alongside with local sales agents and leaders.
Contact provider office
Contact Pharmacy
Handling of escalated issues
Communication
Interaction with peers, sale agents and leadership- Collaboration and resolution
Representatives must document and track all interactions based upon CMS guidelines, participate in interdepartmental discussions and planning and assist the Enterprise Test and Learn Committee in measuring retention impact.
Work Location : Specialists should live and work in the respective Market.
Required Qualification
2 years of customer service experience, preferably in a role focused on customer retention and resolving/preventing customer issues.
Previous inbound and/or outbound call center or related customer service experience
Excellent verbal, listening and written communication skills
Aptitude for quickly learning and navigating new technology, systems and applications
Proficient in Microsoft Office Outlook and Word
Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems
Bilingual- Spanish
Preferred Qualifications
Required Qualification
2 years of customer service experience, preferably in a role focused on customer retention and resolving/preventing customer issues.
Previous inbound and/or outbound call center or related customer service experience
Excellent verbal, listening and written communication skills
Aptitude for quickly learning and navigating new technology, systems and applications
Proficient in Microsoft Office Outlook and Word
Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems
Bilingual- Spanish
Preferred Qualifications
Associate's or Bachelor's Degree
Healthcare experience and/or sales or business development
Clerical support background in a healthcare environment
Familiarity with medical terminology
Medicare experience strongly preferred
Scheduled Weekly Hours
40
New York City Pay Range
The compensation range represents a good-faith estimate of starting pay at the time of posting and may vary based on geographic location and/or employment type. Individual pay decisions will vary based on demonstrated job-related skills such as education, experience, certifications, etc.
43,500-59,925
Pay Type
Hourly
Incentive
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Company info
Humana Inc.
Website : http://www.humana.com