Customer Service Specialist (Healthcare)

We are looking for Customer Service candidates for our Direct Client.

Position: Customer Service Specialist

Location: Farmington Hills, MI

Duration: 3 months (short-term contract)

Pay Rate: $20/hour on W2

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

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

OpTech is an equal opportunity employer and is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, status as a parent, disability, age, veteran status, or other characteristics as defined by federal, state or local laws. https://www.optechus.com/eeo_self_identification/