Job Description

Job Description

Job Description

Community Health Network of Connecticut, Inc. (CHNCT) is currently seeking a Call Center Representative, Tier 1.

Important: This position will be filled through selected staffing agencies for a temporary Call Center Representative. Please be sure to indicate the staffing agency that you are working with on your application. Call center and/or customer service experience is required. Bilingual, English/Spanish speaking candidates strongly preferred. Please note: This temporary assignment is remote and full-time, 40 hours per week.

Primary Responsibilities:

• Community Health Network’s Call Center Representative Tier 1 is responsible for answering member /provider questions via telephone, written or electronic media on specified lines of business as assigned, documenting inquiries, grievances, providing accurate and timely information to callers regarding benefit and network information and all other issues as indicated.

Tasks Performed:

• Answer incoming inquiries from members and providers, ensuring high level service and productivity; consistently adheres to all privacy and security standards in verifying caller’s ID and ability to share PHI; verifies member eligibility and/or provider participation using appropriate data sources; responds accurately and appropriately to member and provider inquiries using appropriate resources; consistently treats members and providers with courtesy and respect as evidenced by review of written documentation, call monitoring and satisfaction survey results; is able to adhere to attendance and productivity standards; resolves routine member/provider concerns received through any media; appropriately escalates complex cases/issues to more senior reps. or management; utilizes language line services when needed; and makes outbound calls or call backs as assigned.
• Documentation is clear/concise stating caller concern, actions taken, next steps/disposition of call.

Essential Functions:

• Answer member and provider requests according to department standards to support contractual requirements: meeting or exceeding ASA of 90% of calls answered within 60 seconds, abandonment rate of less than 5%; hold time of less than 3 minutes.
• Consistent use of PhonePro skills and; techniques; accurately identify, assess, document and address caller needs and steps taken to fulfill those needs.
• Appropriately assesses need for referral to ICM/ other programs and community resources; demonstrate appropriate adherence to department standards evidenced through department audit results; seeks assistance when appropriate; documents/researches inquiries grievances promptly; maintain and seek to expand knowledge of program requirements and benefits; utilizes resource materials to ensure accurate information is provided; adheres to CHNCT's company policies.
• Documents clear/concisely.
• Computer proficient.
• Performs other tasks as required.
• Representatives must have adequate space and privacy to accommodate a work at home set up.
• This is a telecommuting position that requires working from a HIPAA-compliant home workspace, via employee-supplied high-speed internet connection on company-supplied computer workstation and telephone technology. Incumbents are responsible for exercising proper care of all company-supplied equipment, and for returning said equipment in good worker upon transfer or termination of employment.

Desired Education: High school diploma or secondary education

Desired Degree: High school diploma or GED

Desired Job Experience: One year in a customer service role in a health care setting. Call center experience or face to face customer service experience.

CHNCT is an equal opportunity, affirmative action employer m/f/d/v and proud of the diversity of our workforce.

Important Note to Applicants: CHNCT as a company feels very strongly that we need to do what we can to help control the spread of COVID-19 infections. Therefore, all employees, contractors, consultants and agency temporary staff are required to be fully vaccinated to work at CHNCT. Reasonable accommodations for medical or religious exemptions will be provided with appropriate documentation for positions that do not have in-person/member visitation requirements.

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