Customer Service Representative - Hometown Health : Job Details

**Customer Service Representative**

Requisition ID: 165603

Department: 110630 Contact Center

Facility: Renown Health

Schedule: Full Time

Shift: Varies

Category: Clerical & Administrative Support

Location: Reno,NV

Position Overview Benefits **Position Purpose**

This position will act as a liaison between Hometown Health and its consumers and customers by handling inquiries, complaints, concerns, education and assisting those customers and consumers in utilizing the resources and services of Hometown Health. The successful Customer Service Representative will use their experience and expertise to interact with other Hometown Health departments, our customers, and consumers in a professional, expedient, and proficient manner to provide the highest level of understanding and service. The candidate will engage with peers, members, and providers to resolve questions and concerns regarding healthcare coverage and benefits. This position identifies potential or existing service related or operational issues for the purpose of increasing customer retention and satisfaction.

Under the general direction of the Customer Services Director, Manager and Customer Service Supervisor, this position is responsible for keeping appropriate staff informed of customer opinions and viewpoints as well as needs.

The incumbent functions as a representative of Hometown Health to provide appropriate responses to its customers and consumers regarding Plan benefits to include, but not limited to eligibility, provider network, referral and authorization process, claims payment, as well as policies and procedures.This will be done in a consistently service-oriented manner to provide the highest level of satisfaction.

Exercises appropriate response procedures on inquiries, complaints and e-mails needing review and additional follow up prior to providing responses.

Has the ability to provide support and guidance in the event that Customer Service Supervisor, Manager, or Director is absent.

This position does notprovide patient care.

**Minimum Qualifications**

Requirements Required and/or Preferred **Name**

**Description**

Education:

Must have working-level knowledge of the English language, including reading, writing and speaking English.High school diploma is preferred and preference will be given to applicants who have earned a degree from an accredited college.

Experience:

Requires two to three years of experience in a position involving public relations or customer service.Two years of experience in a position directly or indirectly associated with group health benefits preferred.Ability to speak Spanish preferred.

Professional:

Must be proficient with Microsoft Office Suite, including Outlook,PowerPoint, Excel and Word andhave the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

Benefits **Customer Service Representative**

**Requisition id:** 165603

**Department:** 110630 Contact Center

**Facility:** Renown Health

**Schedule:** Full Time

**Shift:** Varies

**Category:** Clerical & Administrative Support

**Location:** Reno , NV

**Position Purpose**

This position will act as a liaison between Hometown Health and its consumers and customers by handling inquiries, complaints, concerns, education and assisting those customers and consumers in utilizing the resources and services of Hometown Health. The successful Customer Service Representative will use their experience and expertise to interact with other Hometown Health departments, our customers, and consumers in a professional, expedient, and proficient manner to provide the highest level of understanding and service. The candidate will engage with peers, members, and providers to resolve questions and concerns regarding healthcare coverage and benefits. This position identifies potential or existing service related or operational issues for the purpose of increasing customer retention and satisfaction.

**Nature and Scope**

Under the general direction of the Customer Services Director, Manager and Customer Service Supervisor, this position is responsible for keeping appropriate staff informed of customer opinions and viewpoints as well as needs.

The incumbent functions as a representative of Hometown Health to provide appropriate responses to its customers and consumers regarding Plan benefits to include, but not limited to eligibility, provider network, referral and authorization process, claims payment, as well as policies and procedures.This will be done in a consistently service-oriented manner to provide the highest level of satisfaction.

Exercises appropriate response procedures on inquiries, complaints and e-mails needing review and additional follow up prior to providing responses.

Has the ability to provide support and guidance in the event that Customer Service Supervisor, Manager, or Director is absent.

This position does notprovide patient care.

**Disclaimer**

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

**Minimum Qualifications**

Requirements Required and/or Preferred

**Name**

**Description**

Education:

Must have working-level knowledge of the English language, including reading, writing and speaking English.High school diploma is preferred and preference will be given to applicants who have earned a degree from an accredited college.

Experience:

Requires two to three years of experience in a position involving public relations or customer service.Two years of experience in a position directly or indirectly associated with group health benefits preferred.Ability to speak Spanish preferred.

License(s):

None

Certification(s):

None

Computer / Typing:

Professional:

Must be proficient with Microsoft Office Suite, including Outlook,PowerPoint, Excel and Word andhave the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.