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Customer Service Representative at Cornerstone

Posted Friday, April 25, 2014 in Medical/Healthcare

The Customer Service Representative (CSR) is responsible for answering and responding to a high volume of telephone inquiries from members and providers. The incumbents responsibilities include providing accurate and thorough interpretation of benefits, eligibility, resolving customer inquiries, facilitating problem resolution, and acting as a member/provider advocate by meeting or exceeding customers expectations. The CSR is expected to take complete responsibility for every interaction with a customer by providing outstanding service as a means to build customer loyalty, improve customer retention and satisfy corporate customer service goals and objectives. Position Responsibilities: 1.Provide timely, accurate, and courteous responses to a high volume of telephone inquiries from both members and providers. 2.Achieve and maintain productivity and quality performance expectations. 3. Interpret and effectively communicate benefits and eligibility information to our customers. 4. Document all critical information related to contacts responded to in the appropriate MHS screen/system. 5. Manage pending inventory in a timely and accurate manner in order to meet or exceed quality and productivity standards. 6.Effectively navigate through multiple complex systems/screens. 7.Provide timely follow-up with other internal departments to expedite resolution of difficult/aging inquiries, and when necessary escalate those issues to management for further handling. 8.Keep abreast of all system, contractual, compliance standard changes and policy updates, and attend additional training sessions as necessary. 9.Complete projects and other research tasks as assigned by area management. 10.Comply with all HIPAA Compliance regulations. Position Requirements: Education: A high school/GED diploma is required. An Associate Degree or equivalent related experience is preferred. Relevant Work Experience: One year experience in Customer Service, Health Care or Health Insurance is required. Previous experience in an ACD call center environment is preferred.

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