About the Role:

As a Customer Service Agent, you are in a highly visible position, being the face of the company to our members and customers. You will handle inbound inquiries, resolve issues, and manage support tickets efficiently. Your ability to communicate effectively, empathize with customers, and provide accurate information is crucial in maintaining our high standards of customer service.

Role Responsibilities:

Answer inbound calls from members and respond to inquiries regarding insurance policies, healthshare plans, claims, billing, and other services.
Provide accurate information and assistance, ensuring a positive member experience.
Address and resolve member issues efficiently, escalating complex cases to the appropriate department or supervisor when necessary.
Create, update, and monitor support tickets within the system (Zendesk/Salesforce).
Ensure tickets are documented thoroughly with relevant details and member interactions.
Track the status of open tickets and follow up to ensure timely resolution.
Maintain a strong understanding of company policies, services, and products to provide accurate and efficient support.
Diagnose and resolve member issues, including billing discrepancies, claims processing questions, and coverage details.
Stay informed about updates to company products, policies, and industry regulations.
Participate in ongoing training and professional development opportunities.
Provide feedback to management on ways to improve the customer service experience.
Actively participate in team meetings and contribute to the development of best practices and strategies for improving the customer experience.
Meet established performance goals, including specific metrics, service level agreements (SLAs), and audit requirements.

Key Competencies:

1 year of experience in the healthcare insurance industry is preferred.
1 year of experience in Customer Service is required.
Available to work an 8-hour shift with a set schedule.
Strong problem-solving skills and attention to detail.
A customer-oriented mindset with a focus on providing high-quality service; patience and empathy when dealing with customers.
Great organizational skills with the ability to prioritize tasks and manage multiple priorities simultaneously.
A flexible mindset with the ability to adapt to changing circumstances and shift priorities at a moments notice.
Demonstrates professionalism in all interactions and maintains a positive attitude under pressure.
Familiarity with CRM and ticketing systems; experience with Salesforce is a plus.
Proficient in using computer applications (Google Suite preferred)
Understanding of HIPAA and ability to handle sensitive and confidential information with care and discretion.
Strong communication skills, both verbal and written. Fluent in English; Bilingual a plus
Legally authorized to work in the United States.