Gathering information and handling customer complaints and escalations.
Developing aggressive retention strategies based on customer feedback.
Negotiating with customers to renew contracts and retain business.
Respond to and resolve, on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as disenrollment requests, benefits, eligibility, and claims
Help guide and educate customers about the fundamentals and benefits of consumer-driven health care topics to select the best benefit plan options, maximize the value of their health plan benefits and choose a quality care provider to retain them in their plan.
Contact care providers (doctors’ offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance
Assist customers in navigating them to their member websites and encourage and reassure them to become self-sufficient
Research complex issues pertaining to the caller’s health, status, and potential plan options.
Meeting with other departments to propose customer retention solutions
Writing and presenting customer behavior reports
Building positive relationships with customers and business associates
Document and update customer records based on interactions.
Assist to reinstate policies due to missed premium payments.
Develop and maintain a knowledge base of the evolving products and services. Core products are Medicare Advantage and ACA-Marketplace options.
Facilitate client exit surveys.
Respond to ticket inquiries from our vendor clients.
Provide retention and trend reports to Management.
Other duties as assigned.
Requirements
Required a college degree or equivalent work experience
Active Group 1- Life and Health Insurance License
Be AHIP certified
Clear a State required background check to obtain and maintain license
Maintain CE to ensure active license status.
3+ years’ experience in customer service, sales and or healthcare, medicare sales related industry
Strong knowledge in CRM systems and Microsoft suite products.
Clear an employer background check.
Bilingual Spanish- English- Mostly Spanish
Initiative-taking; upbeat attitude with high energy level
Pharmaceutical skills
Excellent customer service skills
Excellent verbal, written communication, and people skills
Empathy and patience
Ability to remain calm and professional in stressful situations.