Customer Services Specialist

Job Title: Customer Services Specialist
Job ID: 79963
Location: Farmington Hills, Michigan


What you will be doing:

• Respond to inquiries by telephone, mail and in person; research and answer inquiries, complaints and appeals by following all department standards, policies and procedures; direct inquiries to supporting departments for appropriate action and resolution.

• Educate existing and potential members on policies, procedures, product offerings, benefit plan and coverage provisions related to all HAP products.

• Document all incoming inquiries accurately in to track member inquiry history and trends.

• Practice and maintain confidentiality to Privacy and HIPAA regulations.

• Proactively seek training and development to enhance skills and abilities.

• Monitor workflow inbox and outstanding cases to ensure that all inquiries receive an appropriate response in a timely manner; contact members (by phone/or in writing), as needed, to ensure timely resolution and follow-up to inquiry.

• Interact with support departments in a professional manner to ensure member needs are met.

• Develop and maintain strong business relationships with inter-departments; continue to self-educate on changes in policies and procedures that occur in other departments which could have an impact on department operations and the servicing of member/customers.

• Attend training and development sessions or continuing education opportunities offered by Customer Service and maintain enhanced skill levels and performance.

• Interact with providers and their staff to obtain information for resolving customer inquiries and complaints.

• Ensure and maintain compliance of all department and corporate standards, policies and procedures.

• Recommend process improvements based on observations and trends identified while interacting with internal and external customers.

• Coordinate and assist with various departmental projects, member enrollment periods, outreach activities and corporate initiatives.

• Perform other related duties as assigned.

What you must have:

• Front desk skills

• Experience with checking in/outpatients

• Customer service experience

• Medical office experience 

For more information about TEEMA and to consider other career opportunities, please visit our website at www.teemagroup.com