Customer Service Representative

Duration: 06 Months+

• Candidates will be working 8:00am-4:00pm/8:30am-5:00pm Monday-Friday OR four 10-hour days working 8:00am-6:00pm or 8:30am-7:00pm (option to take off Tuesday, Wednesday, or Thursday for four-day schedule)

• Receive inbound calls; calls may involve claims status, rejections & benefit information; proficient computer skills.
• Communicate effectively with members of Client’s Health options.
• Initiate outreach efforts, primarily by telephone, to conduct screening/surveys of members who may benefit from Care Coordination assistance. (Ex. Members who have needs relating to Physical Health, Behavioral Health, and Health Related Social Needs (SDOH)
• MUST be available to start on 1/16/2024 as this is the only training date for this team.
• High school diploma/GED
• 1-3 years of Screening/Survey experience preferred.
• 1-3 years of Customer service experience required (open to candidates with more than 3 years' experience)
• Must be comfortable working in a high call volume position (100 calls a day, with 50 being outbound calls and 50 being inbound calls)
• Must be proactive, self-directed, assertive, and creative in problem solving and system planning.
• Strong active listening skills with the ability to act sensitively toward diverse people and situations. Ability to successfully interact with external customers, peers, colleagues, and management team.
• Demonstrate effective time management skills and demonstrate an ability to prioritize and handle multiple tasks simultaneously.
• Demonstrate effective time management skills and demonstrate an ability to prioritize and handle multiple tasks simultaneously.
• Must demonstrate sound judgment and discretion when approaching problems and making decisions.
• Training will be 6 weeks long and will be shortened/extended depending on the staff’s need.
• Prefer candidates who are familiar with Delaware, local resources and the DE Medicaid population but it is not required.
• Minimum of 1-3 years of Call Center experience preferred.
• Previous medical experience preferred, previous outbound member outreach and the ability to escalate preferred.
• Experience with pediatrics preferred.

Bilingual candidates preferred