Customer Service Professional

Call Center and Administrative duties; inbound calls, verify & authorize community care based on eligibility criteria, assist in refilling or renewing of prescriptions, sending electronic messages to primary care teams on behalf of patient, utilizing numerous advanced patient systems in support of multiple clinics to include scheduling, canceling, re-scheduling patient's community care appointments, patient advocacy and various in person support duties in medical center.

Handle large volume of inbound calls from Medicare beneficiaries, Group Employer Accounts and assist with Pharmacy Services. Explain and educate members on coverage and benefits. Assist with obtaining authorizations/referrals for specialty services, coordinate care, address, and resolve complex issues within benefit parameters, heavy data entry and document creation. Meet and exceed monthly metrics set forth. Follow and abide by Medicare laws for privacy and other healthcare regulations.

Provided direct leadership to team of 15/25 front line customer service agents both in office and
remote. Conduct on going coaching within monthly one on one meetings, trained team members on CRM communication systems and metrics to include Chat and Email functions. Conduct interviews and assist in hiring decision for new candidates. Assist with on boarding and set up of new agents and provide general agent support. Meet and exceed monthly metrics set forth as a team, encourage and promote top performers, enforce systems policies, and procedures.

Handle large volume of incoming calls, chats and respond to emails regarding order, shipping or
return status. Provide product information; assist with online accounts and profile updates, as well as technical related concerns. Call disposition and complete member follow ups. Resolve member concerns utilizing first call resolution method, address complaints in a professional manner. Meet and exceed monthly call center metrics.