Medicare Customer Service Representative

Position Overview:
Bloom, the insurance industry’s trusted growth partner is seeking an experienced and dedicated Medicare Customer Service Health. Plan We are seeking collaborative, committed, holistic, and evolving personalities. The CSR is responsible for helping members access community resources, arrange transportation, and will assist members with accessing care. The CSR conducts outreach activities to conduct initial health screening and schedules initial visits with newly enrolled members. The CSR will work in a call center-like queue responding to inbound calls from members.

We are looking for an exceptional individual who can:
Function as the first point of contact for our client's members
Communicate with members in a courteous, respectful, and professional manner
Demonstrate exceptional care and compassion for our members
Field inbound calls, as well as conduct outbound calls for member outreach
Provide first-call- resolution for member issues
Escalate, document unresolved issues, and reroute them to the next level of support
Follow communication scripts and use knowledge of the company’s products and services to support member needs
Schedule member appointments as needed, provide status updates for prior authorization, handle member claims questions, and provide the member with an explanation of benefits.
Provide assistance with the replacement of member ID cards
Conduct social determinates of health, and provide release assessments for members
Maintain or exceed key performance indicators and quality performance based on established metrics
Document all activities through appropriate systems and channels
Empathize and remain patient with difficult callers
Excellent attendance, along with consistent dependability and flexibility in the workplace
Evaluate information to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery
Complete required training and understand how to use tools available to recall necessary information and take appropriate action
Consistently support Bloom’s compliance policies and maintain the privacy and confidentiality of information
Develop an understanding of the way performance and actions affect Bloom’s Call Center performance initiatives (call handling, first call resolution, member retention, and performing proper follow-up as warranted)
Utilize dual monitors and leverage computer-based resources to find answers to customer questions
Must be able to work evenings and weekends, if needed
High school diploma or GED
6 months of Medicare healthcare customer service required
Perform all other duties as assigned.

Qualifications:
High school diploma or GED
A minimum of 6 months of Medicare healthcare customer service experience required

Required Skills and Abilities:
Written and verbal fluency in Spanish language preferred
Excellent customer service skills
Proficient computer skills
Active listening and soft skills
Critical thinking skills
Ability to multi-task in a fast-paced environment
Self-motivator
Excellent verbal and written communication skills
Ability to successfully handle a high volume of inbound and outbound phone outreaches
Ability to hold a calm, respectful tone and professional demeanor while under pressure
Performance-driven mindset
A solutions-minded team player
Positive can-do attitude
Ability to meet or exceed established call center productivity metrics
Ability to meet or exceed established goals on all call monitoring audits
Ability to learn and navigate through multiple different systems