Call Center Representative 2

<strong>At CNSI, we strive to be the market leader and most trusted partner for innovative and transformative technology-enabled solutions that improve health outcomes and reduce costs. We&rsquo;re passionate about helping our clients improve the health and well-being of individuals and families. We succeed when our clients succeed.</strong>

Cheyenne, WY

CNSI

<strong>CNSI delivers a broad range of health information technology enterprise solutions and customizable products to a diverse base of state and federal agencies. We align, build, and manage innovative, high-quality, cost-effective solutions that help customers achieve their mission, enhance business performance, reduce costs, and improve health for over 51 million Americans.</strong> https://www.cns-inc.com/

keywords: customer care,summary,support,critical thinking,performance,management,teamwork,research,communication,experience,values,education,scheduling,compensation

Full-Time

Overview: This Call Center Representative 2 is a front-line service position aiding Wyoming Benefits Management System and Services (WY BMS) members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims, and authorization of services from members or providers. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall expectations are to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call. Performance expectations are to meet or exceed operations production and quality standards. This position is in Cheyenne, Wyoming.
Responsibilities: <ul> <li>Responsible for meeting call handling requirements and daily telephone standards as set forth by management; accurately respond to inbound phone calls and processing provider and member inquiries and requests into the appropriate system and database.</li> <li>Independently resolve customers&rsquo; service or billing complaints by demonstrating sound judgement; contact customers to respond to complex inquiries or to notify them of claim investigation results and any planned adjustments.</li> <li>Independently resolve customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction; refer unresolved customer grievances, appeals, and claim resolution to designated departments for further investigation.</li> <li>Actively listen and probe callers in a professional and timely manner to determine purpose of the calls; keep records of customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken.</li> <li>Independently research and articulately communicate information regarding member eligibility, benefits, services, claim status, and authorization inquiries to callers while maintaining confidentiality.</li> <li>Assist efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.</li> <li>Assist in the mentoring and training of new staff.</li> <li>Assume full responsibility for self-development and career progression; proactively seek and participate in ongoing training sessions (formal and informal).</li> <li>Educate providers on how to submit claims and when/where to submit a treatment plan.</li> <li>Independently perform necessary follow-up tasks to ensure member or provider needs are completely met.</li> <li>Support team members and participate in team activities to help build a high-performance team.</li> <li>Thoroughly document customers' comments/information and forward required information to the appropriate staff.</li> <li>Escalate calls to Call Center Lead when necessary.</li> </ul>
Requirements: <ul> <li>You are a High School graduate or have equivalent experience and 2-4 years customer service-related experience.</li> <li>You will be available to work from 7:00 AM to 6:00 PM Mountain Time on all State business days, Monday through Friday (excluding Wyoming State holidays).</li> <li>You possess good verbal and written communication skills, attention to detail, customer service skills and interpersonal skills.</li> <li>You can work independently and manage your time and can accurately document and record customer/client information.</li> <li>You have previous experience with computer applications, such as Microsoft Word and PowerPoint.</li> <li>You have prior experience with public health plans (or general health plans) and basic knowledge of billing/claims and healthcare policy preferred.</li> <li>You must to agree to observing service for the purpose of training and quality control.</li> <li>You must be a proficient typist (avg. 35+ WPM) with strong written and verbal communication skills.</li> <li>You must be able to maneuver through various computer platforms while verifying information on all calls.</li> <li>You must be able to talk and type simultaneously.</li> <li>You must be flexible in scheduling and comfortable with change as customer service is an ever-changing environment.</li> <li>If you can speak Bilingual Spanish, it would be &ldquo;a plus&rdquo;.</li> </ul> <p><strong><em>About Us:&nbsp;</em></strong></p> <p>At CNSI, we strive to be the market leader and most trusted partner for innovative and transformative technology-enabled solutions that improve health outcomes and reduce costs. We&rsquo;re passionate about helping our clients improve the health and well-being of individuals and families. We succeed when our clients succeed.</p> <p>Innovation and commitment to our mission are core to our DNA. And through our shared values, we foster an environment of inclusion, empowerment, accountability and fun! You will be offered a competitive compensation and benefits package.</p> <p>CNSI is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, marital status, genetic status, family responsibilities, protected veteran status or any other status protected by applicable Federal, State, or Local Law. We are proud of our diversity and encourage all qualified applicants to apply.</p>