customer relations Remote
Job description
In order to be considered for this role, apply at this link: https://lumeris.wd1.myworkdayjobs.com/LC/job/St-Louis-MO/Customer-Service-Associate-I_R0006098
Position Summary
Join Our Growing Team!
* $16/hour
* Pay Increases Every 3-6 Months During The First 2 Years
* Performance-Based Incentive Up To $225 Each Month
Job Description
As a Customer Service Associate, you will have the opportunity to apply your superior customer service and communication skills to help our members live healthier lives. By applying your active listening and critical thinking skills, you will be empowered to help our country’s aging population receive the best health care available and get the most out of their benefits.
Why Join Our Team?
At Lumeris, you will be part of a team that is focused on solving the nation's healthcare problem, and you will be able to contribute to our purpose. In addition, you will have:
- Defined career growth and long-term opportunities – including scheduled pay increases every 3-6 months, totaling a 19% pay increase over the first 2 years of employment
- Shift differential pay for nights and weekends
- Ability to earn monthly incentives based on individual performance
- Peer recognition program and other team-based rewards and recognition programs
- Frequent advancement opportunities
- Continuous learning environment including ongoing coaching as well as classroom (virtual and in-person) and computer-based training
- Choice of three unique medical plans
- Prescription Drug, Dental, Vision, Life, and Pet Insurance
- Employee Contributions for HSA and FSA accounts
- 401K with Company Match
- Paid Time Off and Paid Holidays
- Tuition Assistance
Job Description Summary
Responsible for answering calls clearly and concisely, responding to questions, and providing guidance on transactions, inquiries, or complaints from both internal and external customers. Documents and resolves inquiries by using established best practices and educates members about available products and services, while adhering to compliance requirements and Centers for Medicare and Medicaid Services (CMS) standards.
Primary Responsibilities
- Responds to customer calls accurately and professionally including correct grammar and a friendly tone while also demonstrating a genuine delight to serve.
- Resolves customer service inquiries for 1-2 communities which could include benefit and eligibility information, billing and payment issues, customer material requests, physician assignments, authorization for treatment, and Explanation of Benefits (EOB).
- Handles escalated situations and acts urgently when necessary
- Makes outbound calls to members, providers, pharmacies, and/or hospitals etc. to resolve issues as needed.
- Investigates and responds to general inquiries while documenting in the system as appropriate.
- Interacts with other departments including Enrollment and Medical Management to resolve issues.
- Adheres to compliance requirements and CMS standards.
- Provides first call resolution for all customers.
Qualifications
- High School diploma, GED, or equivalent
- Familiarity with computer, Windows PC applications, and the ability to learn new and complex computer system applications
- Working knowledge of Microsoft Outlook, Word, Excel, and PowerPoint
- Solid verbal communication skills including the ability to speak to associates and customers at all levels
- Ability to be detail oriented and organized
- Strong investigative and problem-solving skills
- Ability to read, comprehend, and accurately follow instructions in a constantly changing environment
- Strong commitment to Service Excellence and delivering a customer service experience that results in a Five Star CMS rating
- Ability to work flexible hours throughout the year; the call center is open from 7am - 10pm CT. Following training, you must be able to work the later shift which could end as late as 10pm CT. The call center is also open on weekends during the busy season.
Preferred:
- 6+ months of related experience
- Prior health care or insurance experience
- Bi-lingual
Working Conditions
- While performing the duties of this job, the employee works in normal office working conditions.
Disclaimer
- The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.
To apply for a position at Lumeris, you must create an account using your email address and a password of your choosing. This account will allow you to receive notifications each step of the way through the job application process. With these updates, you'll never have to wonder where you are in the process. Lumeris is an EEO/AA employer M/F/V/D. For more information, go to www.lumeris.com.
Time Type: Full time
Job Type: Full-time
Pay: $16.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Parental leave
- Referral program
- Vision insurance
- Work from home
Experience level:
- 1 year
Shift:
- 8 hour shift
- Day shift
- Evening shift
- Morning shift
- No nights
Weekly day range:
- Monday to Friday
- Weekends as needed
Work setting:
- Call center
- Remote
Work Location: Remote
