Customer Service Representative
Miami (Kendall), FL
About the Client:
AvMed is one of Florida’s oldest and largest not-for-profit health plans, providing Medicare Advantage coverage in Broward and Miami-Dade counties, Individual and Family coverage in Miami-Dade, Broward, and Palm Beach, and coverage for Employer Groups in more than 30 counties across the state.
About the Role:
AvMed is seeking customer service professionals to provide a high quality level of customer service to plan members by answering complex benefit & enrollment questions, resolving issues and providing education in a continuous call volume atmosphere. This role will be responsible for the intake of grievances and appeals as necessary ensuring that all concerns are responded to and resolved appropriately; with first call resolution whenever possible.
Some responsibilities include:
- Adhere to all regulatory requirements relating to member confidentiality, documentation, quality, and inquiry response time
- Responsible for processing policy changes, taking payments; verifying and reviewing invoices
- Communicate effectively with members, agents & employers groups regarding billing and enrollment discrepancies and questions
- Educate on the policy termination and policy reinstatement processes
- Receive and professionally respond to member inquiries, both verbally and in writing
- Obtain and evaluate all relevant information to handle inquiries and grievance using required resources, offering alternatives and options striving for first call resolution
- Consistently document relevant details of comments and actions taken and accurately categorize all inquiries within designated software applications
- Generate standard letters within designated software applications
- Identify and escalate priority issues reporting to department chain of command ensuring follow up to complicated customer calls when required
- High school diploma or equivalent.
- Prior experience working in a health care related field
- Call center experience preferred
COVID-19 Safety Protocol:
Our offices are currently operating at a reduced capacity with our team splitting their time in-office and at-home. Any employee operating from our offices is required to wear a mask or face covering and will be distanced 6 feet apart, as recommended by the CDC's safety guidelines.
An initial questionnaire will be administered before entry is permitted to determine if there is any potential risk. We thank everyone for their cooperation during this time.
*Interviews will be scheduled virtually, please ensure your devices have capabilities to communicate via Skype, FaceTime, Zoom, Google Hangouts or Microsoft Teams.
Interested? Apply directly now or call (Dade: 305-595-3800 / Broward: 954-437-0070) for more information. Questions? Email [email protected] for more information on this role and others.
*CAREERXCHANGE® is an equal opportunity employer. We will present the most qualified candidates to our clients based on the skills required to perform the job. For additional opportunities please visit www.careerxchange.com