Job Description
Job Description
LOCATION: Rochester, NY
DURATION: 6-months contract **High potential to extend**
PAY RATE: $20.00 an Hour on W2 with optional Limited Benefits (not employer-sponsored)
ONSITE
Summary Description:
Under the general direction of the Supervisor, performs a variety of functions including responding to all member inquires through incoming phone calls, faxes, email, and written correspondence, providing accurate responses in a timely manner. Accountable for providing a positive member experience by consistently showing professionalism, empathy, and respect in their interactions with both internal and external customers. In accordance with established policies and procedures, performs a variety of administrative and member support tasks. Responsible for contributing to meeting and/or exceeding the service level goals and compliance in accordance with corporate performance guidelines and standards set forth by the Medicare Division and the Centers for Medicare and Medicaid Services. Accountable for meeting individual performance goals established by management.
Essential Resource Responsibilities / Accountabilities:
Level I
✅ Participates in the training needed to learn regulations, legacy systems, procedures, develop skills and initiate actions to accurately fulfill all requirements of the job
✅ Responsible for maintaining accurate and up-to-date knowledge of all Medicare Advantage regulations and possess the ability to communicate to members in a clear and concise manner to ensure understanding of the products
✅ Including but not limited to competitive plans, health care financing, CMS, and trends and concepts that impact managed health care
✅ Demonstrates a thorough understanding of the Grievance & Appeal process and timeframes
✅ Demonstrates a complete and thorough understanding of all subscriber agreements, amendments, marketing materials, and program
✅ Researches, interprets, and responds to inquiries from internal and external customers, business partners and special groups concerning our products, services, and policies in accordance with CMS, NCQA and legislative requirements
✅ Continues to develop necessary skills to resolve customer inquiries expertly, accurately, and efficiently in an organized manner, resulting in acceptable accuracy and production levels, and retention of subscriber contracts
✅ Deals effectively with upset customers in an empathetic and professional manner and takes responsibility for conflict resolution.
✅ Responds to customers in a professional, efficient manner to encourage public acceptance of corporate products, services, and policies
✅ Identifies patterns generated by external and internal action effecting customer satisfaction
✅ Identifies and follows through on potential issues affecting the insurance industry
Minimum Resource Qualifications:
Level I
Post-secondary education with the equivalent of 2-4 years formal education/training and/or public business experience
NYS Life, Accident & Health License
Knowledge of Medicare Division and the Centers for Medicare and Medicaid Services
A Bachelor's degree is preferred
Effective and diplomatic communication skills including oral, written and listening- Organizational, reasoning, and problem-solving skills
Strong keyboarding and PC Skills required
Knowledge of coverage and lines of business products, services, and policies
Medical terminology is desirable
Physical Requirements:
Must be able to function for long lengths of time sitting at a desk using a keyboard.
Will need the ability to use a headset to listen to customer conversations
Company DescriptionW3R Consulting is a Southfield, Michigan based staffing and consulting firm that provides talent, technology consulting and advanced analytics solutions to Fortune 500 companies in the automotive, financial, healthcare, insurance, professional and business services, and retail industries. In 2012, w3r acquired Nurse Now Staffing. inner of numerous customer and industry awards, this year W3R celebrates 22 years of innovation, exceptional customer service and community engagement.
Company Description
W3R Consulting is a Southfield, Michigan based staffing and consulting firm that provides talent, technology consulting and advanced analytics solutions to Fortune 500 companies in the automotive, financial, healthcare, insurance, professional and business services, and retail industries. In 2012, w3r acquired Nurse Now Staffing. inner of numerous customer and industry awards, this year W3R celebrates 22 years of innovation, exceptional customer service and community engagement.