About the position
Maximus is seeking a Senior Outreach Customer Service Representative (CSR) to provide exceptional customer service to clients and community members regarding the selection, enrollment, and eligibility requirements for various Texas Health and Social Services Programs. This role is crucial in ensuring that clients receive accurate information and assistance in navigating the complexities of health and social services. The Senior Outreach CSR will utilize their extensive knowledge of enrollment requirements, program information, and policies to effectively assist clients both over the phone and in person. In this position, the Senior Outreach CSR will be responsible for identifying, developing, and building relationships with community, state, and faith-based organizations to enhance Maximus's presence in the community. This outreach is essential for fostering connections that can lead to improved service delivery and community engagement. The role requires a proactive approach to customer service, with a focus on addressing complex inquiries and resolving issues efficiently. The Senior Outreach CSR will also be tasked with staying updated on managed care relevant to supported client programs, adhering to processing guidelines, and ensuring compliance with contract requirements. This includes managing complaints, assisting with health plan enrollment and disenrollment, and fulfilling duties as directed by the Complaint Unit Supervisor or Project Management. Performance standards will be outlined in annual criteria, and the role includes the potential for quarterly bonuses based on performance. The position emphasizes the importance of customer service, requiring the representative to handle non-routine calls and adapt responses based on customer needs.
Responsibilities
- Provide effective customer service via telephone and in person to clients and community members.
- Assist clients with the selection, enrollment, and eligibility requirements for Texas Health and Social Services Programs.
- Identify, develop, and build relationships with community, state, and faith-based organizations.
- Stay updated on managed care relevant to supported client programs.
- Adhere to processing guidelines, protocols, and contract requirements for complaint processing and handling PHI/PII.
- Assist consumers in health plan enrollment, disenrollment, and transfers when necessary.
- Fulfill assigned duties directed by the Complaint Unit Supervisor or Project Management.
- Meet performance standards outlined in the annual criteria and bonus template for the position.
- Address complex customer service inquiries and problems over the telephone.
- Manage situations needing adapted responses or extensive research based on customer needs.
- Utilize computerized systems for tracking, information gathering, and troubleshooting.
- Handle escalated or unresolved calls from less experienced representatives.
Requirements
- High school diploma or GED required.
- 1 year of relevant professional experience required, or equivalent combination of education and experience.
Nice-to-haves
- Experience in customer service within health and social services sectors.
- Familiarity with managed care programs.
- Strong communication and interpersonal skills.
Benefits
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Health savings account
- Life insurance
- Paid Time Off (PTO)
- Holidays and sick leave
- Tuition Reimbursement
- Employee perks and discounts
