Representative, Customer Service l (REMOTE IN MD)

Military, Veterans and Diverse Job Seekers; United States; Remote; USD 32,000 - 46,000; Full time

Job summary

Military, Veterans and Diverse Job Seekers is seeking a customer service professional for a Maryland-based MSCC contact center. You will handle member inquiries, coordinate information with health plans and facilities, and resolve issues to maintain high service standards.

The role emphasizes strong communication, problem solving, and adherence to privacy and procedure. Candidates should have at least two years of customer service experience and a high school diploma or GED.

Qualifications

• Minimum two (2) years of customer service experience required.
• High School Diploma or GED required.
• Must pass Classification Assessment.
• Minimum typing speed of 30 WPM (Typing test must be current within one (1) year of the posting period).
• Excellent written and verbal communication skills.
• Demonstrated analytical and problem-solving skills.
• Working knowledge of systems used within the MSCC.
• Ability to read and respond briefly, clearly and effectively.
• Ability to think critically and problem solve.
• Call center experience preferred.
• Health insurance experience preferred.

Responsibilities

• Respond professionally to inquiries from internal/external customers.
• Initiates contact with the appropriate Health Plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed.
• Evaluates data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery.
• Documents according to procedure.
• Follows established procedures to meet customer needs.
• Required to effectively interact with diverse work units and relevant organizational departments.
• Has substantial understanding of the assigned skills and applies knowledge and skills to complete a wide range of tasks.
• Ability to understand relevant policies, processes and customers.
• Assist the department in meeting customer needs and reaching department expectations.
• Completes required training and understand how to use tools available to recall necessary information.
• Develop a full awareness of the way performance and actions affect members and Member Service Contact Center's (MSCC) performance guarantees (call handling, first call resolution, complaint resolution compliance, member retention, and return contact as warranted).
• Promotes, ensures and provides customer service to internal/external customers by demonstrating skills which are consistent with the organization's philosophy of providing extraordinary customer relations and quality service.
• Consistently supports compliance and the Principles of Responsibility by maintains the privacy and confidentiality of information, and protects the assets of the organization.
• Performs other relevant duties as required.

Skills

Customer service

Communication

Typing 30 WPM

Analytical skills

Problem solving

MSCC systems

Clear writing

Critical thinking

Call center

Health insurance

Education

High School Diploma or GED

Job description

Location: Maryland, United States

Essential Responsibilities:

• Member Core: Facility Inquiry, Web Support, Promote KP.Org, Order ID Card, Complaint, ID Card Inquiry, Service Review.

• Member Adv.: Eligibility Inquiry, Benefit Inquiry, General, Complaint, Correspondence Inquiry, Add/Remove Dependent, Service Review, New Member Experience, Internal Regional Request, IVR Defaults

• Medicare (For up to two (2) regions.)

• Premium Billing Enterprise: Billing Inquiry, Make Payment, Complaint, EFT Inquiry, General, Reinstatement Request, Service Review,

• KPC Billing, 1095 Tax Form, SLP* (escalations to Tier 3)

• Represents Health Plan by answering and documenting all incoming contacts to determine their nature and to respond to complex calls related to specialized product lines or queues.

Responds professionally to inquiries from internal/external customers.

• Initiates contact with the appropriate Health Plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed.

• Evaluates data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery.

• Documents according to procedure.

• Follows established procedures to meet customer/member needs.

• Required to effectively interact with diverse work units and relevant organizational departments.

• Has substantial understanding of the assigned skills and applies knowledge and skills to complete a wide range of tasks.

• Ability to understand relevant policies, processes and customers.

• Assist the department in meeting customer needs and reaching department expectations.

• Completes required training and understand how to use tools available to recall necessary information.

• Develop a full awareness of the way performance and actions affect members and Member Service Contact Center's (MSCC) performance guarantees (call handling, first call resolution, complaint resolution compliance, member retention, and return contact as warranted).

• Promotes, ensures and provides customer service to internal/external customers by demonstrating skills which are consistent with the organization's philosophy of providing extraordinary customer relations and quality service.

• Consistently supports compliance and the Principles of Responsibility by maintains the privacy and confidentiality of information, and protects the assets of the organization.

• Performs other relevant duties as required.

Schedule:

Mon, Tue, Thu, Fri 12:30PM-9:00PM, Sun 10:30AM-7:00PM

Basic Qualifications:

Experience

Minimum two (2) years of customer service experience required.

Education

High School Diploma or General Education Development (GED) required.

License, Certification, Registration

N/A

Additional Requirements:

Must pass Classification Assessment.

Minimum typing speed of 30 WPM (Typing test must be current within one (1) year of the posting period).

Excellent written and verbal communication skills.

Demonstrated analytical and problem-solving skills.

Working knowledge of systems used within the MSCC.

Ability to read and respond briefly, clearly and effectively.

Ability to think critically and problem solve.

Preferred Qualifications:

Call center experience preferred.

Health insurance experience preferred.