Respond to customer inquiries ranging from routine to complex from members, clients, providers, and internal/external business partners; inquiries may range from telephone, in person, or via the internet/e-email
Contingent on the Line of Business (LOB), requires in-depth knowledge in the following areas:
- Prescriptions, Plans, Products, Services, and Procedures
- Online purchasing & e-Commerce knowledge
- Internet knowledge
- Payment processing/payment collections
- Eligibility verification
- Order Status, Shipping Status, and Stock Availability
- Accurate completion of necessary documentation, letters, and forms processing
- Quality Assurance testing for company software
- Research and resolve issues/complaints and determine appropriate resolution(s)
- Solve problems and assist with issues that may not fit the “cookie-cutter” solution
- Effectively educate and influence customers and prospective customers on the value and benefits that the company offers through its products, services, and solutions
- Identify customer trends and communicate to appropriate business partners, leaders, and divisions; suggest necessary corrections, changes, or solutions; appropriately elevate situations that could have organization-wide impacts
- Effectively maintain specific line of business Customer Service standards and support level standards
- Remain current on all changes to Customer Service policy, procedures, and product/services/solutions information to respond to customer inquiries accurately and consistently
- Contingent on the LOB, may require attendance at benefit fairs, open enrollment meetings, and client meetings to provide information to attendees; available for occasional overnight travel
- Contingent on the LOB, may support Sales Representatives for any inquiry related to their customer orders
- Contingent on the LOB, may be the first point of contact for Sales Representatives, not related to customer orders
- Contingent on the LOB, may process claims based on business needs and workflow fluctuations
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Job Specifications
Typically has the following skills or abilities:
- One to two years of customer service experience in handling moderate to complex customer inquiries in a call center, insurance, manufacturing, software, telecommunications, retail, or eyewear industries
- Available to work any shift, including weekends, holidays, and/or overnight
- Demonstrated internet knowledge and understanding of basic internet browser settings
- Demonstrated ability to work with multiple software programs simultaneously
- Working knowledge of MS Office package
- Effective verbal communication skills to prioritize multiple tasks and to be available for incoming calls and inquiries
- Effective written communication skills to clearly document customer situations, as well as prepare letters to confirm agreements made
- Excellent interpersonal and rapport-building skills
- Ability to ask appropriate and relevant questions to identify customer needs
- Proven problem-solving, negotiations, and decision-making skills
- Ability to use appropriate discretion and judgment in applying customer/call handling guidelines
- Ability to listen, process transactions, and interact with customers simultaneously in a fast-paced environment
- If this position acts as a third-party administrator (TPA) for processing payments, then candidates will be subject to a credit check