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Customer Services Specialist

Leading Utilities Organization

Customer Services Specialist Strategic Staffing Solutions is currently looking for a Customer Services Specialist for a W-2 contract opportunity! Location: Farmington Hills, MI Schedule: Onsite Duration: 3 months (13 weeks with opportunity for extension) Role Type: W2 Contract Work Hours/Shifts: Must be able to work flexible shifts, overtime including evenings and weekends as requested and/or scheduled. Top Skills: Minimum of two (2) years of recent Customer Service or Call Center experience within the last three years. Fundamental understanding of HMO/PPO/POS delivery system and claims billing. Demonstrate efficiency in using a PC and various Microsoft programs. Education: -Course in Medical Terminology (required completion within six months post-employment). -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. Engagement Summary: This position has the following primary objectives with respect to customer relations for all HAP product lines: (1) Provide follow-up and courteous and prompt resolution to member inquiries by conducting thorough investigations and fully educating members and customers; (2) Support corporate and departmental goals, member enrollment activities and product implementations; (3) Research, investigate and resolve service failures. Improve the customer experience by identifying root causes, trends and recommend resolutions for service recovery and retention; (4) Educate members and prospective members to promote HAP as the health care coverage of choice. Skills 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. 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 supporting departments for appropriate action and resolution. -Educate existing and potential members on policies, procedures, product offerings, benefit plan 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; contact members (by phone/or in writing), as needed, to ensure timely resolution and follow-up to inquiry. -Interact with support departments in a professional manner to ensure member needs are met. -Develop and maintain strong business relationships with inter-departments; continue to self-educate on changes in policies and procedures that occur in other departments which could have an impact on department operations and the servicing of member/customers. -Attend training and development sessions or continuing education opportunities offered by Customer Service and maintain enhanced skill levels and performance. -Interact with providers and their staff to obtain information for resolving customer inquiries and complaints. -Ensure and maintain compliance of all department and corporate standards, policies and procedures. -Recommend process improvements based on observations and trends identified while interacting with internal and external customers. -Coordinate and assist with various departmental projects, member enrollment periods, outreach activities and corporate initiatives. -Perform other related duties as assigned. "Beware of scams. S3 never asks for money during its onboarding process."

Vacancy posted 10 hours ago
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