The Inbound Call Center Representative (CSR) answers all incoming calls from sponsors, members, and providers
Researches claim status, and assists in bringing resolution to the claim problem by thorough analysis.
Outbound calls are made by the CSR to close the communication loop with the caller as required and the CSR must manage this process to coincide with lulls in call center inbound call volumes

Handle high volume inbound calls supporting members with counseling when selecting appropriate health care plans to meet their needs
Accurately document member information and call notes
Provide members with accurate information and a positive experience to all callers (callers may also include local county offices)
De-escalate callers when handling complaints and escalating when appropriate
Handle up to 3 incoming chat sessions simultaneously
Complete offline work as needed

Inbound Call Center Representative

Key skills