Customer Service Representative

- High School Diploma or GED - Minimum of 1 year experience in managed care or a call center handling high call volumes - Previous experience in a hospital setting - Proficient in MACESS documentation inquiries and managing complaints - Capable of addressing escalated issues such as transportation requests and special appointments - Ability to assist management with special projects, including PCP monthly projects and error reports - Skilled in recording customer interactions and maintaining an accurate tracking system - Experience in conducting member orientations, both in-person and via telephone - Competent in processing and resolving complaints while updating systems - Knowledgeable in PCP selection, assignment, and demographic updates - Ability to provide information on member benefits and services - Experience in retention efforts, handling Medicare overflow calls, and outreach projects - Proficiency in managing inquiries related to rosters, disenrollments, providers, and claim billing - Capable of scheduling marketing appointments for prospective members - Strong customer focus and integrity - Excellent written and verbal communication skills - Functional and technical skillset in the relevant area