Customer Service Representative

Ormond Beach, Florida
Customer Service & Call Center (Office and Administrative Support Occupations)
Job Type
Temp to Perm
Working Hours
8:00 AM - 5:00 PM
US$ 12.00 - US$ 12.11 per hour
Ref. Number
Pantoja, Victoria, Spherion
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Job Description

The Customer Service Representative position requires proficiency in answering phone calls, responding to emails, online chat, and in person support related to inquiries, complaints, grievances, & appeals. Must be accurate and efficient in researching benefits and assisting members in understanding their plan. The CSR must be timely and proficient in documenting all communication with members.

- Ability to triage calls to appropriate person
-Documents calls in system using appropriate codes, grammar and spelling.
-Accurately determine reason for call
- Respond appropriately to member complaints/inquiries.
- Must receive call, answering promptly, professionally and always courteously following the Division Policy and Procedure for Phone Etiquette.
- Act as a member advocate, while at the same time presenting and justifying the Organization's actions in relationship to the individual Grievance.
- Work as a team to assure maximum coverage of the Department.
- Maintains electronic case files in the approved format.
- Takes an active involvement in Performance Improvement.
- Works with other departments when identifying continuity of care issues on new members.
- Adheres to company safety and hazardous materials policies.
- Is familiar with and adheres to the company compliance plan, and all HIPAA regulations.

Working hours: 8:00 AM - 5:00 PM

Excellent verbal and written communication skills
Must be able to type a minimum of thirty (30) wpm with ninety (90) % accuracy.
Proficient in Microsoft Word/Outlook and basic keyboarding skills required,
Must be capable of multi tasking
Strong problem solving, organizational and time management skills necessary.

High School

1-4 years

- Working knowledge of ICD-9 and CPT coding preferred.
- High School Diploma a minimum of two years of college preferred.
- Two (2) years of experience with a Managed Care Organization preferred.
- Two (2) years experience in the healthcare industry, preferably in public relations, Customer Service, or compliance/state & federal regulations preferred.
- Comprehensive understanding of Benefits' and Patient Rights is preferred.
-Knowledge of Medical terminology preferred.

Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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