Responsible for handling member issues that require extended time to resolve. May require extended phone calls or working with the member in the office either at the corporate headquarters or the Senior Center. May require multiple phone calls to assist with appointments, social issues, human services or as a liaison between senior services and the member.
- Graduation from High School. Bachelors degree in Social Work or similiar profession preferred.
- Experience working with the elderly or geriatrics preferred.
- Experience with "face to face" customer service.
- Three years previous customer service experience. Managed healthcare or insurance industry preferred.
- Prior claims examining experience preferred.
- Cross trained and functional on three or more lines of business.
- Thorough knowledge of HMO plans, enrollment, benefits and claims.
- Excellent oral and written communication skills with the ability to produce a well written and formatted letter.
- Demonstrated ability to relate and interact with all types of individuals.
- Ability to maintain professional courtesy, discretion and confidentiality at all times.
- Ability to complete tasks in a timely manner.
- Highly organized and attentive to detail.
- Proficiency in personal computers, especially word processing application as well as working knowledge of database applications.
- Excellent problem solving skills.
- Bilingual preferred.
- Ability to converse and write fluently in English.
- Successful completion of Health Care Sanctions background check.