Member Specialist

Company: Addison Group
Location: Houston
Posted on: January 15, 2021

Job Description:

Job Description:* This role is a customer service position with the purpose of working with members to successfully obtain all pertinent information to be able to have them matched with the appropriate legal representation. * This role works in a call center environment handling inbound and outbound calls from and to members and providers. * This role works in a team environment and is expected to consistently maintain metrics/KPI's as defined by management.Duties and Responsibilities:* Answer incoming emails in a timely manner as defined by the Service Level Agreements* Quickly determine the caller's needs and proceed to handle the intake of information and assist the caller* Confirm eligibility when necessary and verify plan benefits* Complete a thorough and accurate case profile during intake* Ensure that the member has a clear and correct understanding of benefits and process before ending the initial call* Attempt to create comfort zones with each member* Work with the team to proactively solve issues* Communicate effectively and in a timely fashion with customers, teammates, and management Notate all applicable information into each case within the CMS* Complete a Daily Status Updates when referrals are not ready the same day or the next day, so that the information can be communicated to the member* Provide Referral information to the member within 30 minutes of completion* Use every available contact method to provide the referral to the member* Follow up within (1) day to confirm that the member received the referral information and was able to reach the attorney unless a success warm transfer call was completed during referral* Follow up with the members until it can be confirmed that the member has had a consultation using the Follow-up Guidelines when you are unable to reach the member* Ensure that the member was satisfied with the consultation and determine whether the member will use the Provider's services, would prefer another Provider, or has received all necessary services* Continue following up with the member until the Providers are completed to ensure satisfaction, at each and every touch point, proactively and after* Report all issues, concerns, complaints and potential problems with Members or Providers using the Escalations Procedures* Respond to all phone messages and emails within two (2) business hours* Report daily activity, using the standard Daily Report format* All other duties as assigned#TalentAdminJob Requirements:Requirements:* High School Diploma, College Degree preferred* Preferred: Minimum three (3) years customer service, insurance, or account management experience* Must demonstrate strong customer service skills, displaying sound judgement and decision-making* Must manage customer expectations by resolving issues in a timely manner* Must plan work appropriately and balance multiple priories* Excellent communication skills, both written and verbal* Must maintain the highest level of professionalism* Microsoft Office proficiencySDL2017

Keywords: Addison Group, Houston , Member Specialist, Other , Houston, Texas