ESSENTIAL DUTIES AND RESPONSIBILITIES
• Verifies member eligibility through THMP and provides support for this activity for the Call Center Representatives, as
needed.
• Acts as a secondary resource to Call Center Representatives in the absence of the Team Lead. Responds to escalated calls
as appropriate and triages to Management, if necessary.
• Assists with processing workflow queues i.e., urgent requests to ensure timely submittal as requested by the Team Lead.
• Assists with onboarding of new hire employees after training in a Nesting environment. Provides the opportunity for job
shadowing and mentorship.
• Knowledge of managed care, Medicaid, call center desktop support applications, customer relations techniques and
general computer literacy.
• Benefits, claims processing or membership knowledge is preferred.
• The ability to work well with the public and adopt a customer perspective and work well individually and in a team
environment
• Effective interpersonal skills and phone etiquette are required
• Strong verbal communication skills
• Good listening skills
H.S. Diploma or GED- Required 3 Years Customer service experience within managed care or
insurance industry Or Call center experience within any industry- Required