November 13, 2024

RPO Inc

CONTRACT

Prior Authorization Specialist

Title: Customer Service Advocate I
Location: REMOTE - DE
Duration: 3* Months Contract* (Potential extension)
Target Start Date (based on successful onboarding completion): ASAP
Shift: 11:30 AM - 8:00 PM EST or 12:30 PM - 9:00 PM EST
Position Purpose:

Serves as the first-line advocate who focuses on resolving inquiries, issues, or concerns for members and/or providers. Leverages a variety of communication channels to provide members and/or providers with timely, accurate, and personalized support on routine complaints. Previously known as Customer Service Representative or Call Center Representative.

Job Description:

Inbound calls from members, verifying, sending out materials. 20-25 calls per day
Receives and responds to routine member and provider inquiries, requests, and concerns in an accurate and timely manner
Mitigates and prevents complaints from being escalated to resolve in the initial contact.
Serves as the front-line resolution advocate on various member and/or provider inquiries, requests, or concerns
Resolves basic problems by communicating the requested information regarding the assessment of the member or provider needs, understanding the cause, and determining if problems need to be routed to other departments for further resolution
Maintains performance and quality standards based on established contact center metrics
Provides customer service in a fast-paced contact center environment over the phone, via live chats and emails
Documents all member or provider information and communications for quality and performance tracking through the Customer Relationship Management (CRM) applications
Remains up-to-date and adheres to quality standards, regulations, and all other policies to ensure quality,

Required Skills/Experience/Education:

1+ years of RECENT Call Center, Customer Service Experience in healthcare/medical setting . Bilingual in English-Spanish is highly preferred.
Strong verbal communication skills, excellent customer service, exceptional phone skills, demonstrated leadership capabilities, ability to problem solve, strong organizational skills, and an exceptional work ethic.
Strong Computer Skills and Microsoft Office (Word, Excel, Outlook), Typing skills (40 WPM), multitasking skills on multiple systems/monitors, must have a stable fast-speed internet connection, and must be connected to secure Wi-Fi (home).
Proof of the highest COMPLETED EDUCATION (Must have an on-hand copy of Diploma/Transcript of your High School or GED. Please note: Technical degrees or certificates are NOT accepted)