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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates strong customer service skills with the ability to manage complex caseloads and maintain member and provider relationships. Proficient in communication and problem-solving to resolve inquiries and concerns effectively.
Highest-signal resume keywords
Customer Service SkillsCommunication SkillsCustomer Retention Skills1 Year Customer Service ExperienceHigh School Diploma or Equivalent
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Tools & Technologies
Ethernet ConnectionCable Modem Internet ConnectionVPN
Industry Keywords
Member RelationsProvider RelationsClaims ResolutionEligibility ConcernsCross-TrainingCustomer SatisfactionProduction StandardsQuality Standards
About the role
Key responsibilities & impact- Resolve customer concerns and provide appropriate education and instruction
- Maintain customer satisfaction and provide a high level of customer service
- Develop proficiency in two or more specialties for one line of business
- Participate in cross-training and improve Customer Service team processes
- Provide guidance on complex issues to customer service representatives
- Manage complex caseloads while meeting production and quality standards
- Organize and distribute work to staff members
- Liaise between members and providers to resolve claims, benefit, and eligibility concerns
- Serve as the primary contact for members, providers, and co-workers
- Maintain member and provider relationships through telephone contact, written correspondence, and on-site visits
- Investigate concerns and issues to ensure accurate information is provided
- Resolve member and provider concerns and inquiries
- Establish and maintain member and provider relations
- Respond to web requests and emails from internal and external contacts as required
Requirements
What you’ll need- High School Diploma or Equivalent (GED) (Required)
- Minimum of 1 year of customer service experience (Required)
- Communication skills
- Customer Retentions skills
- Customer Service skills
- Quiet, dedicated, private, distraction-free workspace at home
- Sufficient space for employer-supplied equipment
- Cable modem internet connection; DSL, wireless cellular, and satellite services are not permitted
- Minimum download speed of 75 Mbps
- Minimum upload speed of 25 Mbps
- Ping less than 150 ms
- Jitter less than 30 ms
- Ethernet connection required; Wi-Fi permitted only when secured using a VPN
- Ability to comply with organization policies and procedures
Benefits
Comp & perks- Healthcare benefits for full-time and part-time positions from day one
- Vision insurance
- Dental insurance
- Domestic partner benefits
- Collaborative, cooperative, and collegial work atmosphere
- Employer-supplied equipment, including monitors, keyboard, and other peripherals
- Work-from-home arrangement