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Customer Services Specialist - Part Time - Health Alliance Plan -Troy

Company: Henry Ford Health System
Location: Troy
Posted on: March 17, 2020

Job Description:

GENERAL SUMMARY:This position has the following primary objectives with respect to customer relations for all HAP product lines: (1) Provide follow-up and courteous and prompt resolution to member inquiries by conducting thorough investigations and fully educating members and customers; (2) Support corporate and departmental goals, member enrollment activities and product implementations; (3) Research, investigate and resolve service failures. Improve the customer experience by identifying root causes, trends and recommend resolutions for service recovery and retention; (4) Educate members and prospective members to promote HAP as the health care coverage of choice. PRINCIPAL DUTIES AND RESPONSIBILITIES:

  • Respond to inquiries by telephone, mail and in person; research and answer inquiries, complaints and appeals by following all department standards, policies and procedures; direct inquiries to supporting departments for appropriate action and resolution.
  • Educate existing and potential members on policies, procedures, product offerings, benefit plan and coverage provisions related to all HAP products.
  • Document all incoming inquiries accurately in to track member inquiry history and trends.
  • Practice and maintain confidentiality to Privacy and HIPAA regulations. Proactively seek training and development to enhance skills and abilities.
  • Monitor workflow inbox and outstanding cases to ensure that all inquiries receive an appropriate response in a timely manner; Contact members (by phone/or in writing), as needed, to ensure timely resolution and follow-up to inquiry.
  • Interact with support departments in a professional manner to ensure member needs are met. Develop and maintain strong business relationships with interdepartments; Continue to self-educate on changes in policies and procedures that occur in other departments which could have an impact on department operations and the servicing of member/customers.
  • Attend training and development sessions or continuing education opportunities offered by Customer Service and maintain enhanced skill levels and performance.
  • Interact with providers and their staff to obtain information for resolving customer inquiries/complaints.
  • Ensure and maintain compliance of all department and corporate standards, policies and procedures.
  • Recommend process improvements based on observations and trends identified while interacting with internal and external customers.
  • Coordinate and assist with various departmental projects, member enrollment periods, outreach activities and corporate initiatives.
  • Perform other related duties as assigned.EDUCATION/EXPERIENCE REQUIRED:
    • Associates Degree or a minimum of four (4) years of recent and related work experience in a customer service capacity may be considered in lieu of the degree.
    • Course in Medical Terminology (required completion within six months of postemployment.
    • Minimum of two (2) years of recent Customer Service or Call Center experience within the last three years.
    • Must successfully complete Call Center Data Entry assessment achieving 75th percentile or higher
    • Must successfully complete Call Center Listening Skills assessment achieving 75th percentile or higher
    • Demonstrate a high degree of integrity, patience, maturity, empathy, tact and diplomacy.
    • Demonstrate problem solving skills, flexibility, good judgment and ability to provide service excellence.
    • Demonstrate the ability to handle assigned projects from start to successful completion including appropriate follow-up and documentation.
    • Demonstrate the ability to handle multiple priorities concurrently in a timely and accurate manner.
    • Demonstrate strong interpersonal, listening, verbal communication and business writing skills.
    • Demonstrate efficiency in using a PC and various Microsoft programs
    • Fundamental understanding of HMO/PPO/POS delivery system and claims billing
    • Must be able to work flexible shifts, overtime including evenings and weekends as requested and/or scheduled. OverviewUnder the leadership of President and CEO Wright L. Lassiter, III, Henry Ford Health System is a$6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sitesincluding medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities andother healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health systemnow has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, oneof the nations oldest physician groups. An additional 2,200 physicians are also affiliated with thehealth system through the Henry Ford Physician Network. Henry Ford is also one of the regions major academic medical centers, receiving between $90-$100 million in annual research funding andremaining Michigans fourth largest NIH-funded institution. Also an active participant in medicaleducation and training, the health system has trained nearly 40% of physicians currently practicingin the state and also provides education and training for other health professionals including nurses,pharmacists, radiology and respiratory technicians. visitHenryFord.com.BenefitsWhether it's offering a new medical option, helping you make healthier lifestyle choices ormaking the employee enrollment selection experience easier, it's all about choice. HenryFord Health System has a new approach for its employee benefits program - My ChoiceRewards. My Choice Rewards is a program as diverse as the people it serves. There aredozens of options for all of our employees including compensation, benefits, work/life balanceand learning - options that enhance your career and add value to your personal life. As anemployee you are provided access to Retirement Programs, an Employee Assistance Program(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits. Equal Employment Opportunity/Affirmative Action EmployerEqual Employment Opportunity / Affirmative Action Employer Henry Ford Health System iscommitted to the hiring, advancement and fair treatment of all individuals without regard torace, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,weight, marital status, family status, gender identity, sexual orientation, and genetic information,or any other protected status in accordance with applicable federal and state laws.

Keywords: Henry Ford Health System, Troy , Customer Services Specialist - Part Time - Health Alliance Plan -Troy, Healthcare , Troy, Michigan

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