Summary
The Customer Service Advocate (CSA-Verification of Benefits) position is designed as an entry level position for the phone unit. The CSA position is the first of four classifications within the Customer Service career path. Once the CSA has successfully completed the training program, the CSA is expected to perform the essential duties and responsibilities competently while maintaining the performance standards cited in the performance section.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
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Under general supervision the Customer Service Advocate listens, analyzes and responds professionally to phone inquiries from internal and external customers.
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The CSA demonstrates a general understanding of policy provisions by competently applying the concepts learned during the training process.
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Competently assesses simple inquiries related to benefits. Facilitates a clear understanding of in network and out-of-network benefits and coverage. Uses appropriate systems to determine procedure codes and applicable coverage.
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Effectively manager’s daily cyber report and follows through on commitments to callers when an inquiry is not resolved at the first contact to ensure customer satisfaction.
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Alerts the supervisor of consistent or repetitive problems which interfere with the timely and efficient processing of inquiries because of internal/external processes in an effort to prevent future problems of similar nature.
Performance Criteria
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Successfully complete the Customer Service Training Program as determined by the Education and Quality staff.
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Maintain performance standards of peer norm productivity, 95% quality, and 94% schedule adherence.
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Working knowledge of Blue Chip and System 80 computer systems.
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In good standing with respect to the attendance, tardy and company and department guidelines.
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In good standing with respect to the objectives citied in the Code of Conduct and Business Ethics handbook.
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Consistently responds to customer inquiries with accuracy.
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Applies Phone Pro soft skill techniques to every call.
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Handles calls without intervention from Specialist or escalation of call.
Supervisory Responsibilities
This position has no supervisory responsibilities