Customer Service Representative

Gallagher is a leading insurance brokerage and consulting firm, and they are seeking a Customer Service Representative. The role involves responding to inquiries regarding claims, benefits, and technical support while ensuring quality service and adherence to call center metrics.

Responsibilities:

• Provide customer service via telephone or email to clients, providers, and plan participants and follow specific call handling instructions for each client or call type
• Refer Provider and Member callers to use online portal registrations, assisting users with logins, and system navigation
• Proficiency in Automated Benefit Claims system, to appropriately educate Providers how to use it
• Expected to take 6 calls per hour/48 calls per day to meet the set standard of production
• With the average speed of answer (ASA) of 30 seconds and an abandonment rate of 3%
• Expected to reach the goal of 20 minutes of after call work per day
• Call hold times should not exceed 2 minutes without following up with the caller
• CRM, open customer service calls should be closed within 15 business days and sooner if urgent
• Understanding of plan benefits and where to find training resources in order to provide current and accurate information to a caller
• Follow technical guidelines related to PC daily shut down, how to manage systems and documents in order to optimize system performance, and must meet at home technical requirements
• Proficiency in all systems used to service our clients, keeping user logins current
• Stay current on emails, ensuring understanding of policies, procedures and relevant information is current when handling calls or emails
• 100% documentation is expected for each call received, unless there is specific instruction not to document a specific call type
• Call quality should be at 90% and above for all call quality audits
• Escalations should be handled according to the caller’s needs, following the documented escalation procedures and appropriate resolution and follow up time
• Proactively communicate with management when training is needed, or time of queue is required to get current on emails
• Check and adhere to daily schedule in Contact Center system, currently Ring Central
• Attendance is an essential part of the job function and excessive unscheduled tardiness, or absenteeism's will be addressed individually
• Review complex or unusual claim situations and review claims previously processed incorrectly and forward to designated personnel with recommended corrective actions
• Reach out to call center leadership, CSR Support for assistance when information is unclear; providing accurate information to customers is imperative
• Must make all efforts to be in Available status when not on a call and communicate to call center leadership about off queue needs in real time. Call avoidance is never acceptable
• Report concerning calls that could turn into complaints to call center leadership immediately
• Report feedback about call center issues, technical issues, CSR performance issues that can impact everyone immediately
• Participate in mandatory team meetings
• Other duties as assigned

Requirements:

• High school diploma
• Minimum of 1 year of customer service experience
• Strong typing and basic computer skills
• Prior customer service background with knowledge of health insurance benefits
• Bilingual (English and Spanish) preferred
• HIPAA and Medical Terminology courses helpful
• Proficient in Microsoft Outlook, Excel, and Word
• Excellent verbal and written communication skills