Responds to member and provider inquiries (phone. written or walk in) regarding all aspects of business, including claims, in a professional, timely, accurate and caring manner while consistently meeting all guidelines.
- Responds to member provider and other inquiries via telephone, correspondence or lobby walk-in while meeting all corporate guidelines and performance standards.
- Demonstrates appropriate customer-care skills such as empathy, active listening, courtesy, politeness, helpfulness and other skills as identified.
- Records, investigates, and resolves member complaints as detailed in the Grievance Procedure narrative.
- Assists in the education of new members and in the re-education of existing members regarding health plan procedures.
- Logs, tracks, and appropriately documents all issues utilizing on-line systems and procedures, and in accordance with all applicable guidelines and requirements.
- Makes decisions that are consistent with the concept of a win-win-win for members & associates
- Demonstrates based behaviors such as initiative, accountability and value.
- Performs skills necessary to create a high-quality customer experience, as reflected through acceptable C-Sat scores, quality monitors and member feedback.
- A High School or GED Required
- 6 months of experience in relevant work Required
- Other Previous experience in a call center or customer service environment Preferred
- Demonstrated written communication skills Advanced
- Demonstrated interpersonal/verbal communication skills Advanced
- Ability to multi-task Ability to multi-task, good organizational and time management skills Advanced
- Demonstrated time management and priority setting skills Intermediate
- Ability to effectively present information and respond to questions from peers and management Intermediate
- Microsoft Outlook Intermediate Required
- Microsoft Word Intermediate Required
- Microsoft Excel Intermediate Required
Randstad is a $22.5 billion global provider of HR services and the second largest staffing organization in the world. From temporary staffing to permanent placement to in-house, professionals, search & selection, and HR Solutions, Randstad holds top positions around the world and has approximately 31,100 corporate employees working from its nearly 4,700 branches and in-house locations in 40 countries.
We are a company built on a deep network of expertise that crosses industries and geographies. We recognize that talent comes in different forms, that every business has its unique challenges and opportunities. And our recruiting experts are skilled at marrying talent and business—identifying the ideal professionals for an organization’s culture and its teams, its needs and its goals.