Consumer Service Specialist III
Posting ID: JP-001971660
Top 5 Must Haves:
1. Customer Service
2. Communication skills
3. Computer Skills
5. Attention to detail
These customer service representatives are responsible for handling calls in regard to enrolling customers in their health benefit plans. They will handle a high volume of calls daily answering questions regarding the various health plans, asking questions of the customer to match them with the proper plan, and assist with the enrollment to get health benefit coverage.
Duties / Responsibilities: Provide assistance to consumers seeking health care coverage including providing information on financial assistance programs and public health care programs (Medicaid, FHP, and CHIP). Process applications for health care coverage via the telephone including building tax household, household income, eligibility determinations, and interpreting of determinations. Process enrollments into QHPs, plan changes, and dis enrollments. Processing of life events and special enrollment periods. Assist Brokers and Navigators with inquiries and eligibility and enrollment issues as appropriate. Transfer/referrals of calls to appropriate entities including in-person assisters, LDSS staff, issuers, other consumer support resources, and SHOP Service Center specialists. Perform co-browse interactions with consumers seeking assistance with the application process via the HBE Portal. Assist customers including prospective enrollees and people assisting enrollees or acting on their behalf, via the phone and web in accordance with all Department and MAXIMUS performance standards, policy and procedures, and protocols. Assist in explaining plan enrollment options including but not limited to covered services, participating providers, and cost. Provides information and direction to callers regarding web-based, mail-in and telephone application/renewals, and other programs as applicable. Facilitates the fulfillment of caller requests for materials via mail, email, or download. Responds to all inquiries consistent with confidentiality and privacy policies and refers callers to alternate sources when appropriate. Accesses, reads, and interprets data elements on all applicable MAXIMUS and state systems to provide support, resolve inquires, and educate callers. Escalate calls or issues to the appropriate designated staff for resolution as needed. Enters appropriate data and information into the applicable systems to process applications and/or update caller information, confirm the accuracy of the customer information and uses every call as an opportunity to provide education and support. Facilitates translation services for non-English speaking callers according to procedures. Attends meetings and training as requested and maintains up-to-date knowledge of all programs and systems. Performs other duties as assigned by management.
customer service, provider services, health services, healthcare, admin, insurance, benefits, Microsoft office, member services, human services, Data entry, Call center, Call center support, Service, Health insurance
Top Skills Details:
customer service, communication skills, computer skills
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Recruiter: Cody Jerome