Job Summary

Serves as the main point of contact a Broker makes with the health plan. Provides exceptional customer service to Brokers by answering questions and/or resolving concerns through appropriate education, information, and follow-up. Ensures Broker satisfaction and a positive experience. The Customer Care Specialist Senior will be a subject matter expert with all broker-related questions. Provides support and mentoring to newly hired staff.

Job Duties

• Provides customers with knowledge of plans, products, systems, and processes to resolve customer issues/concerns.
• Serves as primary contact for customers.
• Maintains strong relationships with customers through telephone contact, written correspondence, electronic messaging and onsite visits.
• Investigates all concerns/issues to assure accurate information is provided in a timely manner.
• Provides resolution for all customer concerns and inquiries.
• Communicates and coordinates with the appropriate internal departments to resolve customer concerns.
• Documents and codes accurately all inquiries/concerns.
• Provides customers with the complaint/appeal and grievance process.
• Documents complaint/appeal and grievances and forwards to the appropriate team for processing.
• Completes outbound calls to customers to resolve complex benefit, eligibility, premium, pharmacy, claims or other related issues.
• Handles multiple lines of business. Assists in training other staff.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

If a suitably experienced candidate cannot be found, applicants who meet the basic qualifications but possess fewer years of experience will be considered for hire at a lower level. Salary would commensurate with experience.

Position Details

Hours - 8:30am - 5:00pm

• Appointments-Application Status relating to broker
• Medicare Application Status
• Over the phone Medicare Applications, during AEP
• Ready to Sell Status-Litmos and AHIP Status
• Credentialing- License Verification, and E&O Insurance Certification
• Contracting- New appointment Inquiries
• Book of Business
• Collateral-Ordering, Cancelling and Status
• Connecture/Broker Portal-Issues and Access Requests
• Broker Commission
• Member ID Cards
• Basic benefits, eligibility for members/groups
• Enrollment representative lookup (in Facets)
• Email invoices (InstaMed)

Work from Home Internet requirements:

Employee required to have/supply: Cable modem, (high speed, only - No DSL or Wireless Cellular Service or Satellite Service) The minimum requirement is:

• 5 MBPS UP
• 20 Mbps DOWN
• <75 ms Ping Required
• <30ms Gitter Required

• Computer must be connected to the internet via Ethernet cable; wifi is not permitted unless a Virtual Private Network (VPN) is used for the wifi connection

Education

High School Diploma or Equivalent (GED)- (Required)

Experience

Minimum of 1 year-Customer Service (Required), Minimum of 2 years-Related work experience (Required)

Certification(s) and License(s)

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.