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LE0008 Castellana Physician Services, LLC

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MMM Holdings, Inc.Job Description

DEPARTMENT: CastellanaPOSITION: Customer Service Representative

POSITION DESCRIPTION

This position is responsible to work as a Customer Service Representative and serve as a primary liaison between customers and the organization in order to provide education, issues resolution, and customer satisfaction. Coordinates care across settings and providers. Communicate telephonically and disseminate written plan information to beneficiaries and network providers.

ESSENTIAL DUTIES AND RESPONSABILITIES

1. The primarily queue of responsibility is the Member assist and visits. As other queues requires backup, this employee may be assigned to support it. 2. Assures coverage of Customer Service call center during normal operating hours.3. Documents member or provider information in system.4. Accomplish established metrics by the Call Center Management on a daily, weekly and monthly basis. Some example metrics are breaks goal (<15%), avoid phone lateness, monitoring score (>90%), Hold Time (<2min), avoid errors found in grievances and issues documented in customer service application etc.5. Forwards performs and/or processes disenrollment, cancellations, reimbursement requests, outbound calls, Member satisfaction surveys, Member orientations, etc.6. Maintain requested registries. Some examples are referrals, 7. Maintain it’s self in continuously learning environment with update information arriving through trainings, emails, one on one’s, staff meeting and any other way. Maintain close communication with Supervisors in order to clarify any doubt about new or current policies and procedures establish. 8. Maintain close communication with Supervisors in order to notify any error made by MMM/PMC or any situation that impact customer service quality.9. Special projects as assigned.

EDUCATION AND EXPERIENCE

Associate degree in health, business related field or comparable experience. Have a minimum of one year experience in healthcare and/or Call Center environment.

Health plan customer service experience preferred. Good communication, interpersonal and problem solving skills.

GENERAL ABILITIES AND KNOWLEDGE

• Computer literate, preferably in the following applications: Word, Excel and Outlook. • Ability to respond to a high volume of work and maintain a polite and professional manner at all times.• Able to function with frequent interruptions.• Ability to prioritize workloads for maximum efficiency.• Able to sit for extended periods of time without compromising work performance.• Customer Service Skills: practicing, valuing and supporting service to both internal and external customers• Time Management Skills: establishing priorities and accomplishing tasks in a timely manner• Team Work: ability to work in a team environment to create solutions to problems.

GENERAL SKILLS

Have strong interpersonal skills. Excellent verbal and written communication skills.English literate.

LANGUAGE SKILLS

Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers.

MATHEMATICAL SKILLS

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.

REASONING ABILITY

Ability to apply common sense understanding to carry out instructions furnished in written or oral form, detailed but not complicated. Ability to deal with problems involving few concrete variables in standardized situations.

PHYSICAL AND MENTAL DEMANDS

Position requires sitting and standing associated with a normal call center environment. Regularly talks and hears. This position requires that weight be lifted or force be exerted up to 10 pounds.

ENVIRONMENTAL AND WORKING CONDITIONS

Working on normal call center environment is required. The noise is typically moderate. Evening or weekend work, as necessary. Working flexible work hours; depending operational needs.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

I acknowledge receipt and review of this job description and understand that it is subject to change.

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