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Health Alliance Plan - Troy, MI
posted 2 months ago
About the position
The Customer Service/Call Center Specialist role at Health Alliance Plan focuses on enhancing customer relations across all product lines. The primary objectives include providing prompt resolutions to customer inquiries, supporting corporate goals, and improving the overall customer experience through effective communication and problem-solving. The position requires thorough investigations into service failures and proactive education of customers regarding health care coverage options.
Responsibilities
- Respond to inquiries by telephone, mail, and in person; research and answer inquiries, complaints, and appeals according to department standards.
- Educate customers on policies, procedures, product offerings, and benefit plans related to HAP products.
- Document all incoming inquiries accurately to track member inquiry history and trends.
- Maintain confidentiality in accordance with Privacy and HIPAA regulations.
- Proactively seek training and development to enhance skills and abilities.
- Monitor workflow inbox and outstanding cases to ensure timely responses to inquiries.
- Interact with support departments professionally to meet customer needs.
- Develop and maintain strong business relationships with inter-departments.
- Self-educate on changes in policies and procedures that impact customer service.
- Attend training and development sessions to maintain enhanced skill levels.
- Interact with providers to obtain information for resolving customer inquiries.
- Ensure compliance with all department and corporate standards, policies, and procedures.
- Recommend process improvements based on customer interactions.
- Coordinate and assist with departmental projects and corporate initiatives.
Requirements
- Associate degree or a minimum of four years of recent and related work experience in a customer service capacity.
- Minimum of two years of recent Customer Service or Call Center experience.
- Completion of a course in Medical Terminology within six months of employment.
- Strong interpersonal, listening, verbal communication, and business writing skills.
- Demonstrated problem-solving skills, flexibility, and good judgment.
Nice-to-haves
- Experience in a healthcare-related customer service role.
- Familiarity with HMO/PPO/POS delivery systems and claims billing.
Benefits
- Health insurance coverage
- 401k retirement savings plan
- Paid time off
- Flexible scheduling options
