Call Center Representative

• Perform outbound calls to obtain appropriate information and document accurately
• Responsible for answering in-bound calls and assisting customers with pharmacy related services
• Maintain strict professionalism in all communication methods while providing efficient, courteous, and friendly service
• Contact insurance companies for benefit investigation and coverage eligibility
• Provide prior authorizations and appeals support
• Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs
• Update job knowledge by participating in educational opportunities and training activities
• Work efficiently both individually and within a team to accomplish required tasks
• Maintain and improve quality results by adhering to standards and guidelines by meeting quality standards set forth by program KPI’s
• Report ADE’s according to program policy and guidelines
• Adhere to all HIPAA guidelines

Bilingual Care Manager – Patient Support Call Center

• Support the Call Center Team and internal departments by advocating on behalf of Providence Medical Group patients.
• Help patients navigate through the managed care system.
• Responsible for the resolution of customer inquiries through multiple channels.
• Upkeep of resources to remain current.
• Coordination of special projects and events.

• Handle telehealth-based phone calls and email inquiries.
• Answer questions about services, provider availability, insurance coverage, visit costs, etc.
• Assist patients in scheduling appointments for virtual consultations with healthcare providers.
• Provide technical assistance in enrolling, scheduling, joining telehealth visits, reviewing account information, etc.
• Investigate patient reports of incorrect costs, refund requests, insurance coverage, etc. and escalate cases to billing department.
• Gather patient feedback on provider quality, ease of use of self-service options, visit connectivity, etc.

Healthcare Call Center Representative

• Support customers by answering inbound calls related to employee and retiree annuity benefits.
• Assist callers with retirement-related inquiries, benefit information, and general questions regarding their benefits.
• Manage a steady call volume while actively listening, navigating multiple systems, and providing accurate and timely resolutions.

Bilingual Benefits Call Center Representative

• Provide triage assessment over the phone utilizing the nursing process, making both independent and collaborative decisions to advise patients.
• Utilize telephone interpretation services to meet the needs of patients where appropriate.
• Provide high-quality customer service and a clinically appropriate and timely experience for patients calling the VGMHC Call Center.
• Coordinate care services for follow-up with the Emergency Department (ED) and internal and external departments/clinics based on patient needs.
• Perform patient education, including explaining to the patient the triage disposition, treatment plan (including use of medications and their effects and side effects if appropriate), infection control (if indicated), and preventative techniques to lower the risk of future disease or accident.
• Offer patients guidance on self-care, medication management, and preventative measures based on clinical protocols.
• Identify care gaps and problem-solve with patients to schedule appropriate appointments with their care team.
• Update on-call providers as needed on the changing needs of complex, high-risk patients.
• Document all interactions with patients and others involved in the care of the patient, accurately, timely, and efficiently in the Electronic Health Record (EHR).
• Communicate problems or concerns immediately to the supervisor to prevent delayed or inappropriate care decisions.
• Maintain up-to-date knowledge and skills in professional, clinical, and system VGMHC areas.
• Perform other duties as assigned.
• Handle protected health information (PHI) in a manner consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

Registered Nurse – Call Center Advice

• Provide exceptional customer service by responding to inquiries, resolving issues, and ensuring members have a positive experience with our products and services
• Answer product-related questions, conduct research, and guide members through procedures
• Help resolve issues, escalate when necessary, and follow up with clients to ensure satisfaction
• Utilize various tools and systems to maintain high standards in service quality and customer satisfaction

Bilingual Contact Center Representative

• Respond to customer inquiries, providing clear and accurate information about products and services
• Research and resolve member issues, escalating when needed to meet service timelines
• Ensure customer satisfaction through effective communication, de-escalation, and follow-up
• Collect and analyze customer feedback for process improvement
• Support division projects related to customer service activities and administrative functions

Contact Center Representative

• Partner with leadership to understand current customer experience and adjust staffing to improve customer experience.
• Create and maintain schedules for Customer Service staff to ensure optimal coverage for service level goals.
• Coordinate with appropriate staff and departments to schedule training, meetings and other events into the workforce management system.
• Administer staff scheduling needs and time off requests in a fair and consistent manner.
• Monitor call center activity and make recommendations for immediate changes to ensure call center coverage meets customers' needs.
• Monitor and record all exceptions to planned schedules to provide current analysis.
• Advise Call Center Management of expected performance concerns and recommend solutions.
• Create and distribute ad hoc reports as needed to analyze trends.

Call Center Analyst, Workforce Management

• Do you enjoy giving superior customer service over the phone, as well as working behind the scenes on a computer? Join our central call center team as a medical Scheduler!
• Scheduling appointments
• Insurance verification
• Routing calls to the correct personnel
• Comfort multitasking from multiple electronic clinical programs and websites

Contact Center Scheduler

• Collaborates with the Director of Contact Center to develop and implement strategies that differentiate member support through exceptional service delivery.
• Fosters a positive, professional, and engaging work environment that encourages enthusiasm, collaboration, and excellence.
• Acts as a subject matter expert (SME) for all credit union policies and procedures, with a special focus on over-the-phone and digital member interaction Provides guidance to leadership and staff to ensure policy adherence and service excellence.
• Designs and oversees a comprehensive Channel Services Quality Management program, ensuring alignment with strategic goals and member satisfaction standards.
• Creates a robust onboarding program tailored to frontline employees and leadership, equipping them with resources, coaching, and support for confidence and success.
• Leads and manages a team of trainers, providing guidance, mentorship, and support to ensure the effective delivery of training programs that align with organizational goals.
• Manages and maintains Channel Services knowledge base content, ensuring it is accurate, up-to-date, and aligned with staff needs.
• Analyzes member feedback from complaints, surveys, and call recordings to identify pain points and collaborates with leadership on solutions to reduce friction.
• Provides actionable insights to various departments and credit union leadership regarding service trends, gaps, and opportunities for improvement.
• Participates in and leads projects related to quality assurance, training, and service enhancement, often stepping into a project management role to ensure deliverables are met and initiatives are successfully implemented.
• Develops and delivers insightful reporting for Channel Services leadership and senior stakeholders, focusing on actionable data to drive decisions. Researches and shares best practices for member and employee engagement, integrating insights into the organization’s culture and processes.
• Ensures service delivery excellence across all interaction channels by tailoring solutions to meet unique member needs.
• Serves as an administrator of and optimizes speech analytics technology, providing training and support for leaders to leverage the platform effectively.
• Serves as a subject matter expert on the service recovery platform, ensuring best-in-class practices for achieving high-resolution rates.
• All other duties as assigned.

Contact Center Training and Quality Operations Manager

• Process clients’ first notice of loss claim reports received through Zurich’s phone & non-phone reporting options in a timely and accurate manner
• Resolve complex claims inquiries and problems, judging when to pass complex queries on to or involve others to provide an effective service and clear advice to colleagues and customers
• Liaise with internal and external clients to exchange information, clarify facts, and resolve queries and/or problems efficiently
• Provide feedback and recommendations to the team to improve the quality of customer care
• Follow procedures to ensure adherence to the company’s risk and compliance policies

Claims Call Center Representative

• Data Entry of ride and billing information for completed rides
• Maintains records and reports within areas of responsibility
• Processes incoming and outgoing mail
• Prepares denial letters to CCO
• Prepares and maintains records for quality control
• Fields incoming phone calls
• Interviews eligible clients to obtain sufficient information to take ride request
• Provides timely ride assignments to providers
• Assesses eligibility according to program regulations
• Documents rides that providers are unable to provide and assists with arrangements for alternative service delivery
• Takes messages and routes calls to other programs

Call Center Specialist

• Manage assigned delinquent consumer accounts and work with customers or authorized parties to identify appropriate repayment or resolution options
• Handle inbound and outbound phone calls related to death notifications, responsible-party outreach, payment discussions, collateral options, and account servicing questions
• Review account documentation and complete follow-up through written correspondence and shared email inboxes as needed
• Navigate multiple systems to document activity accurately, maintain account records, and support timely resolution
• Partner with internal teams across collections, recovery, lien release, repossessions, and related life-event support functions
• Follow established procedures, quality standards, and call schedules while helping minimize loss to the organization

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