Job Description

Tittle: Customer Services Specialist

Location: 21000 E 12 MILE ROAD, SUITE 100, ST CLAIRE SHORES, MI

Duration: 13 Weeks

"Job Summary:

• This position has the following primary objectives with respect to customer relations for all HAP product lines:
• Provide follow-up and courteous and prompt resolution to member inquiries by conducting thorough investigations and fully educating members and customers
• Support corporate and departmental goals, member enrollment activities and product implementations.
• Research, investigate and resolve service failures. Improve customer experience by identifying root causes, trends and recommend resolutions for service recovery and retention.
• Educate members and prospective members to promote HAP as the health care coverage of choice.

Duties and Responsibilities:

• Respond to inquiries by telephone, mail and in person; research and answer inquiries, complaints and appeals by following all department standards, policies and procedures; direct inquiries to support departments for appropriate action and resolution.
• Educate existing and potential members on policies, procedures, product offerings, benefit plans and coverage provisions related to all HAP products.
• Document all incoming inquiries accurately in to track member inquiry history and trends.
• Practice and maintain confidentiality to Privacy and HIPAA regulations.
• Proactively seek training and development to enhance skills and abilities.
• Monitor workflow inbox and outstanding cases to ensure that all inquiries receive an appropriate response in a timely manner"

"Required Skills & Experience:

• Minimum of two (2) years of recent Customer Service or Call Center experience within the last three years.

Must be dependable.

• Demonstrate a high degree of integrity, patience, maturity, empathy, tact and Diplomacy.
• Demonstrate problem solving skills, flexibility, good judgment and ability to provide service excellence.
• Demonstrate the ability to handle assigned projects from start to successful completion including appropriate follow up and documentation.
• Demonstrate the ability to handle multiple priorities concurrently in a timely and accurate manner.
• Demonstrate strong interpersonal, listening, verbal communication and business writing skills.
• Demonstrate efficiency in using a PC and various Microsoft programs.
• Fundamental understanding of HMO/PPO/POS delivery system and claims billing.
• Must be able to work flexible shifts, overtime including evenings and weekends as requested and/or scheduled.

"Required Education:

• Course in Medical Terminology (required completion within six months postemployment).
• Associate’s degree

OR

• A minimum of four (4) years of recent and related work experience in a customer service capacity may be considered in lieu of the degree.

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