Tr. Cust Support - HealthCare

Job DescriptionJob title Tr Customer Support Officer Contact Center (Band 5, Level 1)Reports to Unit Manager / Asst Unit ManagerProvides customer service support for third party administrators, Health Maintenance organizations, preferred provider organizations, managed care organizations and many more in US healthcare insurance market by identifying and updating information.The ultimate motive is to ensure commendable service standards and maintain very high customer satisfaction.Key ResponsibilitiesAgent would log on to the workstation and they log into the client application through his specific id and pull enrollment documents relating to the customer.The agent would make an outbound call to Payer to get missing information on the form.Once the forms are updated, they are sent back to processing team to complete the task and would be data verified by the QC member. There is also call monitoring done for all agents to ensure quality standards are met and feedback is given on a regular basis by QA and managerStaying current with knowledge of products/ processes & services offered by the clientEnsure full adherence to all the quality parameters.Ensure 100 percent adherence to schedule.Meeting all defined targets like Productivity, quality, Maintenance of required reports in Excel.Responds to provider and member phone inquiries in a timely manner provides accurate responses in a professional and courteous mannerResearch inquiries using appropriate team members and Applications as resourcesAssists team with providing claim or Plan status for client inquiriesUpon Customer request, modify or add details to the Medicare Advantage Plan in the Application. Follows up with provider and member calls to obtain further information internal departments may request, as neededEnsures that HIPAA guidelines are followed in every communication with providers, clients or staff.Essential Job FunctionsLook up for relevant information and update (type into) the client systems as per set procedures and policies.Attention to detail while accomplishing tasks, meeting Weekly / Daily targets with required quality in the given timelinesAdhere to the team norms for making the overall team a cohesive one.Ability to prioritize and manage workload.Must be ready to work in night shiftsBehavioral SkillsDetail-oriented with ability to focus for extended periodsAbility to work independently, seeking supervision as neededAbility to communicate professionally, clearly and effectively, verbally and in writingAbility to have superior attendance to effectively fulfill all functions of the positionAbility to independently follow through on assigned tasks, without promptingAbility to prioritize effectivelyAbility to multitaskCommunicates clearly and concisely, with sensitivity to the needs of othersMaintains the confidentiality of all company procedures, results, and information about participants, clients, providers and employeesMaintains courteous, helpful and professional behavior on the job; displays a willingness and ability to be responsive in a warm and caring manner to all customer groups. Consistently cooperates and supports organization in problem solving issueEstablishes and maintains effective working relationships with co-workersFollows all Policies and Procedures and HIPAA regulationsParticipates in any recommended or required training sessionsMaintains a safe working environmentQualificationUndergraduate (10+2)/Diploma / Graduate (Only Arts or Science) – Non-Technical OnlyGood communication skills.MIS experience – 1 yearsAdvance excel minimum 1 yearExcellent analytical, problem-solving, and communication skills.Detail-oriented with the ability to handle sensitive and confidential information.Ability to work independently and as part of a team.Strong organizational skills and ability to manage multiple priorities.Educational requirements include a High School Diploma or GED equivalent.Prior customer service experience is required (Inbound or Outbound Calls). Two years of professional work experience in a health plan call center is strongly preferred.Exposure to health plan management operations is preferredKnowledge in Medicare Plans preferredGeneral knowledge of medical terminology preferredKnowledge and experience using current computer technologyWorking knowledge of Excel and Word.Skilled in establishing and maintaining effective working relationships with clients, and staff at all levelsSkilled in problem resolution; recommends suggestions to increase accuracy and/or efficiencyAbility to work independently with minimal supervisionAbility to communicate professionally, clearly and effectively, verbally and in writingAbility to prioritize effectivelyAbility to multitaskExperience And Skills Requirement For This RoleShould be good with MS Office and reporting.Strong analytical and problem-solving skillsStrong experience in MS office (MS Excel, Power point, Word etc)Minimum 1 year of voice experienceBasic computer knowledge requiredTyping speed minimum 25-35 WPM with 85 percent accuracyShould be open to work in any shift (Monday – Friday) including US shift (9 PM IST to 7 AM IST)Working ConditionOffice-based environment with standard business hours.May require extended hours during peak periods or audits.Regular use of computer systems and phone communication.