Call Center Customer Service Representative (Health Insurance)

: Description:

AFSPA is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity and Affirmative Action Employer, making decisions without regard to race, color, religion, sex, sexual orientation, national origin, age, veteran status, disability, or any other protected class.

All new hires will be required to comply with Association policy pertaining to COVID-19 Vaccination. COVID-19 vaccination is not required but strongly recommended. Failure to adhere to policy guidelines will result in disciplinary action up to and including termination

*A Resume is required for consideration. Application submissions without a resume included will be automatically disqualified from consideration.*

Compensation for this position is in the $42k range to $ 47k range depending on qualifications and experience. This position is eligible for a $500 Signing Bonus after 90 days of successful completion.

Hybrid work schedule until otherwise notified. Hybrid work schedules are based on business needs and may require you to have to work in the office up to 4 days per week.

Summary : Handle incoming calls and correspondence from customers in a call center environment. Provide accurate detailed responses to customer inquiries and move issues to a successful resolution based on the benefits outlined in the Health Plan's Brochure.

Duties & responsibilities include, but are not limited to the following:

• Appropriately service customers regarding benefits, service, and medical care issues. Provide timely and accurate information to incoming calls, emails, and written correspondence from customers regarding claim status and health benefits*
• Ensure that complaints & appeals are processed in accordance with regulations, compliance standards, policies, and procedures. *
• Request customer address changes, claims inquiries, and portal requests according to established departmental policies and procedures. Work closely with business partners to resolve customer issues
• Identify and elevate appropriate issues to the supervisors/management staff
• Route claims requiring an adjustment to the Plan's administrator and ensure all relevant information needed to reach a successful outcome is provided.
• Completely and accurately, document all interactions necessary to handle customer issues in an accurate and timely manner.
• Follow up with customers as needed to update them on the progress of open issues and the resolution of closed issues in a timely manner
• Return customer calls within 48 hours. *
• Handle individual and other assigned Queues in Navigator and ASD
• Conduct yourself in an appropriate manner per the code of conduct in the employee handbook (section 4).
• Other duties as assigned.

Requirements:

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The HBO II position is an inbound call center position, and it entails a 90-day FULLY IN-OFFICE TRAINING that includes tests throughout the training period. You are required to have a minimum of 85% or above passing score on all tests. There are 3 phases of training:

• Brochure - Open book assessment
• Systems - Various databases
• Phones - Taking live calls

Education/Experience : High School Diploma or equivalent and a minimum of 3 years of customer service experience in an office environment required; Attention to detail and problem-solving skills.

Work Location: The following are work locations that AFSPA utilizes: New Carrollton, Maryland Office; Washington, DC Office; and Hybrid-Remote. This is not a fully remote position. Work location will be assigned and/or changed based on business needs and at Management's sole discretion.