Humera - Administrative and Professional Staffing

Customer Service Representative II

7 days left

Location
Minnetonka, MN, United States
Salary
Contact For Rate
Posted
Jun 17, 2018
Closes
Jun 26, 2018
Job Type
Employee
Employment Status
Full Time
Humera is looking for qualified candidates to fill multiple Health Plan Specialist II positions at our client located in Minnetonka, MN. This is a contract position with a large health care insurance organization.

This entry-level position is responsible for managing all inquiries from active, terminated, and prospective members of the company. The Health Plan Specialist II is a primary contact for members to resolve service problems for claims, enrollment, billing, pharmaceutical as well as interpreting contracts and explaining benefits. They are responsible for exceptional levels of service satisfaction, providing quality service, and the service recovery process. The service recovery process is critical to the success of the department. The Health Plan Specialist II will use this process to assist members in complex situations.

The degree of client satisfaction and retention Medica achieves with membership is directly related to the success of the customer service teams. The Health Plan Specialist II is responsible for identifying, researching and resolving member and all other internal and external customer concerns, problems and issues in a timely and courteous manner. Health Plan Specialist III's are expected to work with enrollment, billing and other departments within Medica to resolve member issues.

The Health Plan Specialist II's typically interact with a number of external and internal customers. External customers include the following: active, terminated, and prospective customers (providers and third-party administrators). Internal customers include: employees in medical management, enrollment, billing, claims, sales/marketing and legal. Outside vendors may include: pharmacy benefits managers, behavioral health and dental providers.

Advancement opportunities are moderate to high. After mastering the claims, pharmacy and benefits skill sets within this position and performing at above standard levels, the Health Plan Specialist II could move into higher Health Plan Specialist tiers. From there, the Health Plan Specialist could move into a Lead, Issue Resolution Analyst, Client Specialist, Quality Administrator, Consumer Affairs Advisor or supervisory position within the department or other Medica departments. Manager positions may be available in Customer Service, Provider Service Center, Special Investigations Unit, Claims Analysis and Recovery, Electronic Commerce and Project Management. A technical route may include IT Service Desk, Business Analyst and Electronic Commerce Specialist positions.
The intention of the Government Programs Contact Center hiring class is to start quality candidates who will be level II (Medicare - CHA).
Medicare Contact Center II - Center for Health Aging (CHA)
  • Supports Medicare member population that has either Individual or Retiree Group coverage with Medica
  • Takes approximately 45 inbound calls per day
The calls received by the candidates will be transactional. This entry-level position is responsible for managing basic inquiries from active, terminated, and prospective members of Medica. The Health Plan Specialist II is a primary contact for members to resolve service problems for claims, enrollment, billing, and pharmacy as well as interpreting contracts and explaining benefits. They are responsible for exceptional levels of service satisfaction.

The degree of client satisfaction and retention Medica achieves with membership is directly related to the success of the customer service teams. The Health Plan Specialist II is responsible for identifying members and researching enrollment requests in a timely and courteous manner. Health Plan Specialist II's are expected to work with enrollment, billing and other departments within
    Education/ Experience:
  • 1-2 years customer service experience required (Call Center, Customer Service, Insurance, Medical/Healthcare)
  • Associate's degree or equivalent work experience required
  • Bachelor's degree preferred

    Skills/ Abilities:
  • Team interaction and support of each other in dealing with customer issues
  • Advanced ability to multi task and manage time efficiently
  • An ability to identify process improvements
  • Provide mentor and peer feedback
  • Develop knowledge of multiple products and platforms
  • Demonstrated ability to learn quickly and respond well to a rapidly changing industry and operational environment
  • Excellent verbal and written communication skills

    Hours:
  • Training is 3-4 weeks and the schedule is 8am-5pm
  • All shifts are performance based. (i.e. higher performing contractors get to choose their preferred shifts)
  • After training the shifts will likely be one of the following, however shifts can change over time:
    8am-4:30pm OR
    9:30am-6pm
  • Contractors may also be expected to work some holidays

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