CCO Service Agent

This is a fully remote position, open to applicants in Florida, +2 more states.

📋 Description

• Assist in the operations of the Contact Center by ensuring members and providers experience outstanding customer service.

• Handle inquiries from members and providers across all Lines of Business.

• Address complaints, provide client education, retain members, assist in preventing dis-enrollments, and escalate issues that require further attention.

• Offer customer service related to eligibility, benefits, claims processes, escalations, and product inquiries.

• Manage inbound and outbound calls, emails, and chats.

• Achieve or surpass quality, productivity, and reliability KPIs.

• Adhere to policies and procedures to resolve issues promptly and accurately.

• De-escalate situations with upset members and providers and facilitate issue resolution.

• Initiate investigations, engage in root cause analysis, implement corrective actions, suggest process improvements, and follow up on unresolved inquiries and complaints.

• Ensure compliance with HIPAA regulations and safeguard confidential Protected Health Information.

• Cultivate relationships with both internal and external customers through transparent communication.

• Be available to work flexible schedules, including late shifts, weekends, holidays, and unexpected business interruptions.

• Undertake additional responsibilities as necessary.

⛳️ Requirements

• High School Diploma or GED from an accredited institution.

• Previous experience in a customer service role.

• Experience in participating in cross-functional projects and departmental initiatives related to customer/client interaction and service.

• Experience working in a fast-paced environment.

• Proficiency in Microsoft Office Suite, including Excel, Word, and Outlook.

• An Associate’s or Bachelor’s Degree from an accredited institution or equivalent work experience is preferred.

• Demonstrated independent thinking, problem-solving abilities, and goal achievement.

• Familiarity with traditional and/or omnichannel contact centers, ideally within the healthcare sector.

• Understanding of KPIs, CMS/NYSOH requirements, CMS STARS programs, and call center operations.

• Experience using various technologies, including a Customer Relationship Management System.

• Basic knowledge of operational health plan departments and their functions.

• Working knowledge of Microsoft PowerPoint.

• Understanding of call center metrics such as Average Handle Time and Quality.

• Exceptional verbal and written communication skills.

• Capability to document emails, communications, and presentations in grammatically correct language.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Incentive and recognition programs.

• Life insurance.

• 401k contributions.

• Competitive compensation and benefits package.