Addison Group

Member Specialist (11:30am-7:30pm Shift)

3+ months agoHouston, TX

Customer Service Representative
Direct Hire
Hourly Pay up to $16.00 depending on experience.
Hours: 11:30am - 7:30pm
Opportunity for Growth!

Addison Group is assisting our Houston-area client with their search for a qualified Customer Service Representative.

Job Description:

  • This role is a customer service position with the purpose of working with members to successfully obtain all pertinent information to be able to have them matched with the appropriate legal representation.
  • This role works in a call center environment handling inbound and outbound calls from and to members and providers.
  • This role works in a team environment and is expected to consistently maintain metrics/KPI's as defined by management.

Duties and Responsibilities:
  • Primary responsibilities include responding to company emails, answering incoming calls, and assisting with customer's inquiries
  • Confirm eligibility when necessary and verify plan benefits
  • Complete a thorough and accurate case profile during intake
  • Ensure that the member has a clear and correct understanding of benefits and process before ending the initial call
  • Maintain positive relationships with each member
  • Work with the team to proactively solve issues
  • Communicate effectively and in a timely fashion with customers, teammates, and management Notate all applicable information into each case within the CMS
  • Complete a Daily Status Updates when referrals are not ready the same day or the next day, so that the information can be communicated to the member
  • Use every available contact method to provide the referral to the member
  • Follow up within (1) day to confirm that the member received the referral information and was able to reach the attorney unless a success warm transfer call was completed during referral
  • Follow up with the members until it can be confirmed that the member has had a consultation using the Follow-up Guidelines when you are unable to reach the member
  • Ensure that the member was satisfied with the consultation and determine whether the member will use the Provider's services, would prefer another Provider, or has received all necessary services
  • Continue following up with the member until the Providers are completed to ensure satisfaction, at each and every touch point, proactively and after
  • Report all issues, concerns, complaints and potential problems with Members or Providers using the Escalations Procedures
  • Respond to all phone messages and emails within two (2) business hours
  • Report daily activity, using the standard Daily Report format
  • High School Diploma, College Degree preferred
  • Preferred: Minimum three (3) years customer service, insurance, or account management experience
  • Must demonstrate strong customer service skills, displaying sound judgement and decision-making
  • Must manage customer expectations by resolving issues in a timely manner
  • Must plan work appropriately and balance multiple priories
  • Excellent communication skills, both written and verbal
  • Must maintain the highest level of professionalism
  • Microsoft Office proficiency

Job ID: AddisonGroup-472393