Job Description
Required Education:
• H.S. Diploma/GED Equivalent
Required Experience:
• Requires successful completion of proficiency testing following initial Advocate training.
• Must successfully complete Customer Service training and successfully pass proficiency exam to maintain CSA position.
• Must successfully complete spelling, grammar, and basic computer skill testing during job interview.
• Must be proficient in typing and basic computer skills.
• Perform well in a fast-paced, stressful work environment.
• Must have good phone etiquette and use effective communication skills (both verbal and written).
• Must be familiar with policies, procedures, and new products offered by Marketing and complete training as required.
• Must be able to multitask.
• Must be knowledgeable in public relations with a diverse customer base.
• Must be able to problem-solve and act as an advocate for the customer.
Job Responsibilities:
• Under general supervision, communicates to Members policies, procedures, and services to ensure complete knowledge of the Plan.
• Must adhere to call handling goals of 80% of calls answered within 30 seconds.
• Helps and adheres to the call abandonment rate of less than five percent (5%) with average hold time not to exceed 2 minutes based on regulatory requirements.
• Within 60 days of employment on the floor, must meet the monthly quality goal of ninety-two percent (92%) or greater based on two percent (2%) of calls monitored.
• Helps and meets schedule adherence goals based on department policy, successful completion of proficiency testing following initial Advocate training.
• Serves as a primary contact for benefits, premium payments, and simple enrollment inquiries for Personal Plans based on first contact resolution guidelines.
• Verifies demographic information on all inquiries and updates the Plan system.
• Helps Members with concerns and effectively works toward a resolution before the concern escalates to a complaint.
• Accesses appropriate sources to obtain benefit information requested by Member.
• Accurately documents phone log records for each inquiry with appropriate messaging based on department standards.