Customer Service Rep - Remote | Wfh

Are you passionate about providing exceptional customer service to veterans? Join our dynamic team at a fast-paced contact center where you will play a crucial role in delivering outstanding care through the Community Care Network (CCN). As a Customer Service Representative, you will handle inbound calls and chat messages, addressing inquiries related to medical and behavioral health care authorizations, provider availability, claims payment, and status. With a focus on first call resolution, you will accurately assess caller requests, process requests, and ensure appropriate call escalation protocols are followed. Additionally, you may have the opportunity to make outbound calls to schedule appointments based on veterans' or VA requests. Your dedication will contribute to resolving administrative eligibility discrepancies through thorough account research and review.
Required
Education & Experience:
High School diploma or GED
One year of experience in a customer service role with performance metrics
Proficiency in using Microsoft Office products and the Internet
Preferred
Healthcare industry experience, including knowledge of health services
Contact center experience, including call center chat messaging
Military experience with a focus on service delivery
Key Responsibilities
Manage multiple task lists within directed timelines, ensuring call volume, chat volume, schedule adherence, quality, veteran appointment, and other production standards are met.
Handle inbound and outbound phone calls, chat messages, and emails from VA medical center staff and providers, addressing claims, eligibility, benefit, and program questions. In select markets, facilitate appointment scheduling for veterans through outbound solicitation to providers.
Demonstrate professional and courteous service skills to both internal and external customers consistently.
Resolve VA and provider inquiries accurately, emphasizing first call resolution.
Safeguard the privacy of patients' health information by complying with HIPAA regulations and taking appropriate measures to protect customer health information.
Document all communications with veterans and providers, utilizing critical thinking in problem-solving and following established processes to ensure quality program compliance.
Meet department productivity and performance metrics, including regular and consistent attendance.
Participate in cross-training, employee development, and flexible assignments to meet business needs.
Competencies
Commitment to Task: Display high motivation and conform to established policies and procedures.
Communication / People Skills: Adapt to different communication styles, listen critically, collaborate, and influence or persuade others positively.
Computer Literacy: Function effectively in a multi-system Microsoft environment, utilizing Word, Outlook, TriWest Intranet, the Internet, and department software applications.
Coping / Flexibility: Demonstrate resiliency in adapting to various situations and individuals while maintaining a sense of purpose and employing a mature problem-solving approach.
Empathy / Customer Service: Exhibit customer-focused behavior, including active listening skills, patience, respect, and empathy.
Information Management: Manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.
High-Intensity Environment: Thrive in a fast-paced environment, handling multiple activities simultaneously while maintaining focus and control.
Organizational Skills: Effectively organize people or tasks, adjust to priorities, learn systems, and meet deadlines with available resources while being detail-oriented.
Team-Building / Team Player: Positively influence the actions and opinions of others, fostering a sense of commitment and collaboration within the team.
Technical Skills: Possess proficient data entry skills and meet daily call and chat requirements.
Company Overview
At our organization, we take pride in taking care of our nation's heroes. Our mission is to ensure that America's veterans are connected to the healthcare they deserve within their communities. Since 1996, TriWest Healthcare Alliance has been at the forefront of this important mission.
Benefits
We believe in rewarding hardworking individuals who are dedicated to their responsibilities and eager to learn and grow. Joining our team opens up opportunities for frequent pay raises, overtime earnings, recognition and reward programs, and much more. We offer a comprehensive and progressive compensation and benefits package, including:
Medical, Dental, and Vision Coverage
Generous paid time off
401(k) Retirement Savings Plan with matching
Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
Tuition reimbursement
Paid volunteer time
Equal Employment Opportunity
We are committed to providing equal employment opportunities to all individuals. Applicants will be considered for positions without discrimination based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or any other factors protected by applicable federal, state, or local laws.
Employment Type: Full-Time
Salary: $ 31,000.00 39,000.00 Per Year