Full-time Bilingual Customer Service Representative
Posted on: October 7, 2021
The customer service representative is responsible for
responding to a diverse membership and their providers as well as
other customers via various communication methods in a timely,
professional and courteous manner.
Your career starts now. We’re looking for the next generation of
health care leaders.
At AmeriHealth Caritas, we’re passionate about helping people get
care, stay well and build healthy communities. As one of the
nation's leaders in health care solutions, we offer our associates
the opportunity to impact the lives of millions of people through
our national footprint of products, services and award-winning
programs. AmeriHealth Caritas is seeking talented, passionate
individuals to join our team. Together we can build healthier
communities. If you want to make a difference, we’d like to hear
Headquartered in Philadelphia, AmeriHealth Caritas is a
mission-driven organization with more than 30 years of experience.
We deliver comprehensive, outcomes-driven care to those who need it
most. We offer integrated managed care products, pharmaceutical
benefit management and specialty pharmacy services, behavioral
health services, and other administrative services. Discover more
about us at www.amerihealthcaritas.com.
Under the direct supervision of the operations supervisor, the
customer service representative is responsible for responding to a
diverse membership and their providers as well as other customers
via various communication methods in a timely, professional and
courteous manner. This includes inbound and outbound member and/or
provider phone calls or correspondence regarding benefit,
eligibility or customer issues. Makes outreach welcome calls to new
members and conduct Health Risk Assessment Surveys as needed.
Provides member education and assists members with PCP selection
and assignments. Assists with access to care and wellness
program. Follows internal processes and procedures to ensure all
activities are performed in accordance with departmental and
company policies and procedures.
Demonstrate passion for providing superior customer service to
our customers and continually seeks to understand the needs of
those we serve.
Answer and respond to a high volume of calls and assist members
and providers with any inquiries in relation to eligibility,
benefits and claims status.
Create accurate and timely member documentation concerning all
inquiries taken in accordance to established protocols to ensure
resolution is provided and presented in a clear and accurate
Present and project a positive image of the company in and out
of the office to fellow associates, members, providers and the
community by being courteous, helpful, energetic, respectful and
Strive to resolve an inquiry on first contact while ensuring
that the inquiries have been addressed to the customer’s
satisfaction by using all resources in an efficient and timely
manner. Follow-up with members, if necessary, in a timely
Communicate complex healthcare information in a way that is
understandable and relatable to members and providers.
Provide feedback and/or solutions to supervisor to ensure
continuous process improvement and provide a better customer
Creates and supports an environment which fosters teamwork,
cooperation, respect and diversity.
Maintain an awareness of all product knowledge
Able to respond positively to support change within the
department and the company.
Willing to be flexible regarding job responsibilities and
schedule, not limited to but including, overtime and holidays, as a
result of contractual business requirements.
Routinely meet or exceed contact center key performance
Perform other duties as assigned.
Associate’s Degree preferred.
Healthcare or Managed Care experience preferred; minimum 45 wpm
typing skills preferred; working knowledge of PC applications in a
windows based environment.
Demonstrated verbal and written communication skills combined
with listening and problem solving ability to identify needs, seek
solutions and resolve customers’ concerns.
Ability to work well in a team environment and willingness to
learn and adopt customer service methods and practices.
Must be bilingual, demonstrating the ability to speak both
English and the target language. Must be able to perform the
responsibilities of the position in either English or in another
language. Languages required are determined by business need.
1 to 3 years customer service/contact center experience
strongly preferred; at least 1 year outbound contact center
experience, desired; healthcare customer service experience,
desired; Medicare experience a plus.
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