Call Center Representative

Provide excellent service to customers through the resolution of basic customer inquiries received by phone or though written correspondence. Responsibilities: Receive customer inquiries via phone, fax, mail, e-mail, etc. If necessary, probe for additional helpful information (i.e. member ID, claim number, name, etc.) in order to effectively handle inquiry. Review computer systems and/or other reference materials to complete verification process. Initiate investigation process based on the nature of the inquiry (claim, member information, benefits, enrollment, appeals, etc.). Utilize available resources to quickly and efficiently resolve or redirect inquiries in accordance with prescribed departmental process. Accurately document customer inquiries and actions taken in accordance with departmental quality guidelines to ensure appropriate follow up. Follow up on unresolved issues in a timely manner, escalating call trends to management. Deliver an excellent customer service experience while meeting quality and production standards. Perform other relevant tasks as assigned by management.

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