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DescriptionThe Consumer Service Operations Representative 3 is responsible for the daily activities across multiple service functions area, including but not limited to mobile touch point locations in the various markets. The Consumer Service Operations Representative 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment.Responsibilities
The Consumer Service Representative 3 will focus on membership retention of current and new members by providing local proactive “high touch” outreach and enhanced member experience. This role includes functions relative to benefits, enrollment and eligibility, member support, claims interpretation and processing, agent support, onboarding, local agency outreach, billing issues, payments, provider questions and call center operations. The Representative will regularly exercise discretion and judgment in prioritizing requests, interpreting and adapting procedures, processes and techniques.
Additional Job Description:The Consumer Service Representative 3 will work alongside a Sales Manager in a specific market by making outbound calls and proactively managing potential member dissatisfaction. Representatives must document and track all interactions based upon CMS guidelines, participate in interdepartmental discussions and planning and assist the Enterprise Test and Learn Committee in measuring retention impact. The focus areas for membership retention are:
Dual-SNP member
Newly enrolled with Humana
Broker/telesales/online enrollment, or an orphaned member
Required Qualifications
High School Diploma or equivalent
1-3 years of customer service experience, including typing/data entry
Previous inbound and/or outbound call center or related customer service experience
Excellent verbal, listening and written communication skills
Aptitude for quickly learning and navigating new technology, systems and applications
Proficient in Microsoft Office Outlook and Word
Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems
2 years of leadership, escalated calls,team lead or similar experience
Bilingual English & Mandarin
Preferred Qualifications
Associate's or Bachelor's Degree
Previous healthcare experience
Clerical support background in a healthcare environment
Familiarity with medical terminology and/or ICD-10 codes
CNA or Medical Assistant background
Quality background
Medicare experience
Additional InformationScheduled Weekly Hours40About UsEqual Opportunity EmployerIt is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailboxtasrecruit@humana.com for assistance.Humana Safety and SecurityHumana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailboxtasrecruit@humana.com to validate the request.