Customer service

CUSTOMER SERVICE REPRESENTATIVE (Medicare & Retiree -UHC)  Handling prescription, claims, medications and set an appointment of the member  Review the medical benefits of the member.  Checking the prior authorization.  Manage payment of monthly premium and billing.  Assisting LEP ( LATE ENROLLMENT PENALTY)  Handles customer’s problems arising from various products supported.  Provides first line voice customer services.  Accepts inbound calls.  Receives transactions from user’s regarding customer service or related needs based upon of scope of support provided by contract to sykes’ clients and ensures that all communication with customer is within guidelines of the client.  Demonstrates a strong customer service orientation and takes responsibility for follow up to insure customer needs and expectations are satisfied.  Determines appropriate action to be taken on customer’s behalf, which may include problem determination and appropriate next steps. Informs customer of those appropriate next steps and work with customer to achieve issue resolution.  Maintains proficiency programs, products and/or platforms assigned and is accountable for providing a response to the customers of our clients.  Follows prescribed problem resolution procedures  Handles customer’s product usage questions.  Communicates with team manager, team members and other teams regarding problems, solutions and trends and communicates with co-workers to research problem and find solution.  Properly escalates product issues that are irresolvable and not available on knowledge base  Ensures that cases and/or callbacks are logged in accordance with the Data Quality guidelines  Reaches and maintains the level of customer service skills are required for the post. Ensures that all data is collected accurately.  Ensures that service levels are achieved as communicated by the Account Manager and/or Account Supervisor.  Responsible for meeting established individual and team performance targets, which include customer service, productivity and quality standards.  Continuously products know-how.  Adheres by Client & Company Policies.  Makes sure that schedule given is adhered to  Attends trainings, workshops, seminars, and focus group discussions scheduled by the team.  Contributes to other projects if requested  Competent in use of all technical methods of communication e.g. email, telephone  Conveys information clearly and effectively both written and verbal  Remains focused on improving clearly and effectively both written and verbal enhancing product knowledge. Able to efficiently comprehend customer’s line of thought