Using exceptional concierge service phone skills consistently provides excellent service when responding to customer and internal telephone inquiries. Employs active listening skills to promptly and effectively gather the information necessary to investigate and resolve member inquiries. Advises members regarding policy benefit, billing and claims information. Communicates service solutions through internal telephone contact, email communications, and computer research, investigates and resolves member and provider inquiries. Coordinates internal processes necessary to research and resolve inquiries and provides accounts with service solutions. Codes and data enter information into computer applications. Uses computer applications and systems to look up and record customer account information and to document and track inbound calls, and issue resolution to maintain files. Identifies and resolves problems or issues that require some probing or analysis within the immediate work team, redirecting more difficult issues or upset members to the leader. Meets or exceeds individual service, production, quality goals. Contributes to the team effort to meet or exceed team service, production, and quality goals. Identifies problems and errors and implements solutions with team members and leaders. Suggests ideas for continuous improvement consistent with enhancing operational efficiency, in alignment with the Company\'s commitment to quality assurance and continuous improvement methodology. Works with the Senior Outreach Consultant Team (Consumer Sales) delivering sales presentations regarding our Medicare products. Responsible for Outbound calling projects that assist in meeting or exceeding our Star Quality ratings with CMS. Member of the Medicare Markets Pulse Team which collaborates with management and associates on special projects.
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