Customer Service Representative – Health Plan

Role Overview

• Quickly assess the level of complexity of cases and provide resolution or facilitate escalation of phone call inquiries.
• Provides positive, consistent customer experiences by striving for excellence in understanding and resolving specific requests while showing patience, empathy, compassion and sincerity.
• Responds to customer questions via inbound and outbound telephone calls and written correspondence.
• Partners with other Sanford Health departments as needed to coordinate on inquiries requiring in depth research to ensure customer satisfaction regarding member and provider questions.
• Thoroughly documents interaction for accurate tracking and analysis.
• Promote the usage of self-service to callers as appropriate.
• Provide end-user support including navigational questions, basic system issue resolution (e.g., self-service), and escalation as applicable.
• Highlight opportunities to address common inquiries through existing or new self-service functionalities.
• Identify opportunities to address common inquiries through improved knowledge management system content and improved methodologies.
• Ensure compliance with all corporate data administration rules, data security standards, as well as Sanford Health policies and procedures.
• Follow all Customer Service policies, processes and guidelines.
• Ability to deliver high quality customer service consistently in a professional manner.
• Ability to follow strict policy guidelines.
• Ability to deal effectively with dissatisfied customers.
• Strong communication skills.
• Flexibility to accommodate staff scheduling changes.
• Strong customer service focus.
• Strong interpersonal and listening skills.
• Ability to handle multiple customer requests in a timely manner.
• Attention to detail (particularly with entering data).

Requirements

• High school diploma or equivalent preferred; bachelor's degree is preferred.
• Minimum of one year experience in providing customer service.
• General computer skills including the ability to use the range of Microsoft products (MS Office, Outlook/Exchange).
• General organizational and proficient problem solving skills.