The incumbent of this role is expected to Provide courteous and prompt resolution to provider/member inquiries by conducting thorough investigations and fully educating provider/member with the goal of resolution on initial contact. I
1. Respond to inquiries by telephone, web chat or email; research and answer inquiries, complaints and appeals by following all department standards, policies and procedures.
2. Creates an exceptional experience for the provider/member by using professional customer service techniques, personalizing and focusing on adding value to the call
3. Retains existing member through the use of proactive customer service/consulting techniques and enabling members to perceive value in the service
4. Resolves member’s questions and concerns efficiently and effectively through the use of active listening and personalizing techniques and by focusing on adding value
5. Resolves problems on the first call, and with a minimum of transfers by consistently improving personal technical knowledge and understanding
6. Manipulate systems and escalate issues to the appropriate personnel for final resolution.
7. Practice and maintain confidentiality to Privacy and HIPAA regulations. Proactively seek training and development to enhance skills and abilities.
8. Participates in ongoing training in keeping with Client’s request and changing business strategies.
9. Ensure and maintain compliance of all department and corporate standards, policies and procedures.
10. Maintains call performance goals (i.e. AHT, quality and schedule adherence)
11. Adheres to Sagility’s policies and procedures.
12. Maintains a positive attitude and support HGS’ Commitment to Excellence.
13. Performs other duties as assigned.