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customer service and participant services specialist - Wilson, United States - Wilson-Mcshane
2 weeks ago
Description
** CUSTOMER SERVICE AND PARTICIPANT SERVICES SPECIALIST**
**Job Category****:** PARTICIPANT SERVICES **Requisition Number****:** PARTI01129 Showing 1 location **Job Details**
**Description**
**Essential Duties and Responsibilities:**
Answer high volume telephone calls from participants and provide explanations and answers related to eligibility coverage, medical claims benefits, and medical claims status.
Review required eligibility information including legal documents, enrollment forms, and coordination of benefits forms.
Work on multiple operating systems such as Basys (claims system) and Multi-fund (Wilson-McShane operating system).
Point of contact for pre/post board of trustee meeting correspondence and follow up.
Mail correspondence to Participants.
Provides assistance with incoming and returned mail.
Prepare documents for mailing projects and scanning.
Assist with related special projects and duties as assigned.
**Essential Skills and Qualifications:**
Bilingual in English/Spanish highly preferred.
A minimum of 1 year of customer service experience highly preferred.
Ability to read and interpret documents such as Summary Plan Description and procedure manuals.
Computer Skills: Proficiency with all aspects of Microsoft Office. Quick learner of other computer applications.
**Individuals should demonstrate the following competencies:**
Customer Service- Respond promptly to customers needs; Respond to requests for service and assistance; Manage difficult or emotional customer situations.
Oral Communication- Speak clearly and persuasively in positive or negative situations;
Written Communication- Write clearly and informatively; Edit work for spelling and grammar; Present numerical data effectively.
Business Acumen- Understand business implications of decisions; Align work with strategic goals.
Professionalism- Approach others in a tactful manner; React well under pressure; Accept responsibility for own actions; Follow through on commitments; Team Player.
Judgment- Display willingness to make decisions; Exhibit sound and accurate judgment; Support and explain reasoning for decisions; Include appropriate people in decision-making process; Make timely decisions.
Quality- Demonstrate accuracy and thoroughness; Strong attention to details; Look for ways to improve and promote quality; Apply feedback to improve performance; Monitor own work to ensure quality; Take pride in own work.
Quantity-Complete work in a timely manner; Strive to increase productivity.
Dependability- Follow instructions, respond to management direction; Keep commitments; Take responsibility for own actions.
Attendance/Punctuality- Consistently at work and on time; Ensure work responsibilities are covered when absent.
Adaptability- Adapt to changes in the work environment; Handle frequent change, delays, or unexpected events; Ability to prioritize duties. Ability to multi-task.
Planning/Organization- Prioritize and plan work activities; Use time efficiently.
**Qualifications**
**Skills**
**Preferred**
**CUSTOMER SERVICE** *Expert* **PLANNING/ORGANIZATION** *Expert* **WRITTEN COMMUNICATION** *Expert* **Behaviors**
**Preferred**
**Detail Oriented****:** Capable of carrying out a given task with all details necessary to get the task done well
**Team Player****:** Works well as a member of a group
**:**
**Motivations**
**:**
**Education**
**Experience**
**Licenses & Certifications**
