HFHP Customer Service Associate - Remote - Per Diem
Remote, USA
Full-time
Posted 2025-03-08
Job Description ? This position is a per diem remote, work from home opportunity if you reside within the state of Florida ... POSITION SUMMARY: To be fully engaged in providing No Harm / Quality, Customer Experience, and Stewardship by: acting as liaison in the Call Center for customer inquiries while focusing on achieving department performance indicators. Success will be based on the individual's sincere desire to serve, as well as the ability to effectively communicate, use resources, manage time and solve problems in professional manner while working in a team to meet common goals. PRIMARY ACCOUNTABILITIES: Quality/No Harm: ? Properly identifying and elevating concerns that affect customers or the Health Plans' ability to serve them. ? Providing accurate and professional service to Customers, adhering to department policies. ? Attending and participating in staff training sessions, surveys and department meetings. ? Maintaining confidentiality at all times, following departmental and organizational confidentiality guidelines. ? Contributing towards meeting departmental performance goals (average speed of answer, service level, abandonment rate). Customer Experience: ? Responding to customer inquiries by researching, understanding and documenting plan information related to: * Covered benefits and exclusions, including prescription drug coverage * Eligibility, enrollment and disenrollment * Participating providers * Claims payments and processes * Authorization processes * Premium billing * Plan guidelines ? Assisting Health First Health Plans customers in a caring and knowledgeable manner, representing the organization as a skilled health care professional. ? Handling incoming sales inquiries from prospective customers by answering basic questions and referring to a licensed sales agent for closure. ? Provide assistance with customer service walk-in members in a timely and efficient manner. Stewardship: ? Meeting individual Call Center performance standards as determined by management. ? Properly identifying and elevating concerns affecting customers or Health Plans' ability to serve them. ? Participating in special projects as requested or approved by management. Qualifications: QUALIFICATIONS REQUIRED: ? The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience. Some college preferred. ? One year related work experience in a call center OR customer service environment interacting with customers. ? Must be able to work the designated shift and overtime as needed. ? Must be able to talk and type at the same time and communicate effectively while multitasking. ? Must be able to navigate through multiple screens and computer applications while reviewing benefit information. ? Ability to accurately type 45 words per minute while speaking with a customer on the phone. ? Intermediate to Advanced computer skills, including Microsoft Applications. ? Bi-lingual Candidates must be able to speak, read, write & comprehend in Spanish and English. ? Certification required by passing, Bi-lingual/Medical Interpretation test, provided by ATLA at Health First CFL. PHYSICAL DEMANDS: ? Ability to sit and view a computer screen for several hours at a time. ? Work effectively in a fast-paced and often stressful environment. MENTAL DEMANDS: ? Excellent verbal, interpersonal, and written communication skills. ? Superior customer service telephone skills, including active listening and questioning skills. ? Basic math, analytical, and problem solving skills. ? Ability to think critically to define issues, identify risks, and propose outcomes. ? Maintaining a high level of motivation, initiative, and accountability. ? Organization, prioritization and time management. ? Ability to interact professionally and work effectively as a team with all levels of employees and management. ? Handling multiple tasks, often within limited time frames. ? Must be able to work in a team environment illustrating cooperation and respect. ? Excellent attendance is required and ability to work a flexible schedule. ? Strong knowledge of customer care processes and techniques
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