Previous Job
Customer Service Senior Representative
Ref No.: 22-10217
Location: Nashville, Tennessee
Senior Customer Service Representative

Location: 100% remote
Pay: $18-23/hr (unknown until first submittal)
Schedule: Core hours 8am - 5pm CST, though outbound calls can be made to a customer from 8am - 8pm in the customer's time zone. Specific shift to be agreed upon with supervisor.
Contract: 12/12/2022 - 2/28/2023

Overall Description:
The Customer Service Senior Representative will conduct outbound calls to customers who are at risk of leaving our plan, customers who are new to the plan, and other ad hoc campaigns as needed. Representative will assist our customers with any concerns that relate to retention of membership and/or general benefits. Representative will help address customer issues and track customer responses. The representative will use call scripts, spreadsheets, and various computer systems in order to assist customers.

  • Delivers specific delegated Customer Service tasks assigned by a supervisor.
  • Receives requests by mail, telephone, or in person regarding insurance claims/policies.
  • Responds to inquiries from policy holders, providers and/or others for information and assistance.
  • Performs research to respond to inquiries and interprets policy provisions to determine most effective response.
  • Mails or routes claim forms and supporting documentation to various units for final processing.
  • Position typically requires excellent interpersonal skills, ability to understand and interpret policy provisions.
  • Independently responds to inquiries, grievances or complaints of moderate to substantial complexity.
  • Completes day-to-day tasks without immediate supervision, but has ready access to advice from more experienced team members. Tasks involve a degree of forward planning and anticipation of needs/issues. Resolves non-routine issues escalated from more junior team members.
  • Conducting outbound calls to customers for various reasons: retention, welcome, and other miscellaneous campaigns
  • Researching benefits, providers, and other concerns for the customer
  • Coordinating with other departments to ensure all customer needs have been addressed
  • Documenting all calls in call tracking systems using numerous computer systems to research and document data, including Microsoft office, claims systems, and call recording software (OneView, Knowledge Xchange, Finesse, OMD, MHK, etc)
  • Ad- hoc duties as needed
  • 5 years customer service experience
  • Healthcare and/or call center experience
  • Preferred: Experience with Medicare/Medicaid
High school diploma or GED

English Read Write Speak
Spanish Read Write Speak