Call Center Outbound Specialist - Apree Health

Description

• Represent apree health, our clients and partners to internal and external customers with World Class Service
• Conduct Outbound Business to Consumer (B2C) calls in a health care setting.
• Utilize enthusiastic and inspirational techniques where the objective is to motivate the member to act upon known discrepancies in their care
• The Specialist will be responsible for navigating the member through their medical health benefits
• The Specialist will possess the personal resilience to work in this environment where the members contacted will not always be receptive to the reason for calling
• Take ownership of resolving customer service and healthcare navigation issues from start to finish; going above and beyond to accommodate our customers’ employees within the boundaries of our established guidelines
• Accurately and completely interpret and explain insurance documents such as Explanation of Benefits (EOB), Medical Billing and work on the employee’s behalf to facilitate understanding or correction of any discrepancies
• Schedule appointments with physician office staff on behalf of the member
• Recommend & educate members on next best actions, benefit programs, services or preventive care activities
• Anticipate the need and locate resources for the removal of barriers to care for the employees of our customers whenever possible
• Document interaction details in Salesforce CRM system
• Ability to work with 3rd party business partners as an advocate for the employees of our customers and stay within the designated scope of responsibilities
• Exhibit a high level of familiarity with our applications and their functionality
• Provide navigation and interpretation of insurance details to employees of High Touch customers including but not limited to: coordination of benefits, new or changing health benefit plans, steerage to appropriate level of care, connecting to high quality, in-network providers and applicable facilities
• Ability to work with 3rd party business partners as an advocate for the employees of our customers and stay within the designated scope of responsibilities
• Adhere to all applicable HIPAA, and other privacy guidelines and applicable laws
• Meet the goals established for the position in the areas of: call quota, attendance and other performance criteria
• Respond to customer service requests within established SLA's via email, phone, live chat, etc.
• Other related duties as assigned
• Willingness to work weekends/evenings and occasional overtime, although this is rare. Typical schedule is Monday through Friday and covers shifts starting as early as 5:45am MST and the last shift ends at 7pm MST.
• Bachelor's degree preferred in a relevant field or equivalent work experience.
• Previous experience preferred in the following areas: healthcare contact center, health care provider, health care billing, wellness, and/or other health care setting
• Relevant outbound calling experience in telemarketing or telesales
• Experience in a healthcare or insurance customer service position is a plus
• Proven customer service skills, professional work ethic and a desire to grow within the wellness profession
• Laser-focused customer attention and dedication to rapid problem solving and thoughtful responses
• Detail-oriented with a strong focus on accuracy and adherence to compliance regulations.
• Impressive organizational skills and attention to detail
• Adept at juggling multiple tasks and customer support requests at the same time
• Able to work both independently and as a member of the team
• Strong communication skills, both verbal and written
• Familiarity with online google suite application tools; Salesforce Service Cloud is a plus
• Experience with assisting customers utilizing mobile digital applications
• High tolerance for changing fast-paced environment and ability to adapt
• Positive, friendly, and professional demeanor with customers
• Must be able to work 40 hours per week
• Spanish speaker a plus
• Limited travel, between 0% and 10%