Customer Service Representative

This position requires individuals to perform the following duties and work as part of a team:• With the goal of first call resolution, the CSR Agent will address the needs of inbound callers according to the established call flows and work processes as supplied by the client and in accordance with accepted coverage guidelines, ensuring all mandated government and state regulations are consistently met.• CSR agent must know when to reach out to internal partners and when/how to internally refer issues ranging from claims, provider searches, location of resources, obtaining an interpreter, referring enrollment issues to backend team and helping callers understand benefits.• With a high level of accuracy and attention to detail, agents must have the ability to maintain professionalism while working within documentation guidelines, on proprietary software on multiple applications. Agents are required to check email accounts daily and stay up to date on call handling resources through continual document review and completion of mandated knowledge checks as assigned.• Agents will live-document all caller interactions in accordance with Quality Assurance Guidelines and will maintain an average monthly rating as defined for the site.• Agents will be in attendance for and will adhere to their slated schedule and will be either on a call, or readily waiting for a call-in order to maintain minimum Production and Adherence standards.• Exceptional attention to detail and willingness to learn, adapt and interact with individuals who may be angry, frustrated or calling in to complain while helping to ease the abrasion between the member and the plan.• Other duties as assigned.