Experienced Senior Customer Service Representative – Remote Opportunity at careerzynith

Are you a customer service professional with a passion for delivering exceptional experiences and making a meaningful impact on people's lives? Do you thrive in a fast-paced, dynamic environment where no two days are ever the same? Look no further than careerzynith, a global organization dedicated to delivering care and improving health outcomes for millions of people worldwide.

As an Experienced Senior Customer Service Representative at careerzynith, you will play a critical role in connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. You will be part of a talented team that is guided by diversity and inclusion, comprehensive benefits, and career development opportunities. Join us to start Caring. Connecting. Growing together.

• *About careerzynith**

careerzynith is a global organization that delivers care, aided by technology to help millions of people live healthier lives. Our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone – of every race, gender, sexuality, age, location, and income – deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

• *Job Summary**

As an Experienced Senior Customer Service Representative at careerzynith, you will be responsible for providing exceptional customer service to our clients, resolving complex issues, and driving continuous improvement. You will work closely with our Subject Matter Experts, business partners, and internal stakeholders to ensure that our clients receive the highest level of service and support. This is a full-time, remote opportunity that requires a strong customer service background, excellent communication skills, and the ability to work in a fast-paced environment.

• *Key Responsibilities**

• Communicate common problems/questions presented by callers to appropriate Subject Matter Experts, to drive continuous improvement
• Educate callers on available products/services (e.g., features, functionality, options, additional offerings, preventive services, age-related services)
• Educate callers on self-service resources available to them, and on their responsibilities with regard to their health care coverage
• Refer callers to other resources applicable to their questions/issues, where appropriate (e.g., pharmacists, prior authorizations, billing department)
• Review/analyze phone support data/metrics and communicate patterns/trends to internal stakeholders, as needed (e.g., leadership, Subject Matter Experts, business partners)
• Provide training/mentoring to other team members, as needed (e.g., new-hires, refresher training)
• Participate in customer site visits, as needed (e.g., to obtain feedback, provide education, clarify support processes, highlight company performance)
• Demonstrate knowledge of applicable health care terminology (e.g., medical, dental, behavioral, vision)
• Demonstrate knowledge of applicable products/services (e.g., benefit plans, disability, COBRA, FSA, HRA)
• Obtain and apply knowledge of benefit structures/designs for contracted or acquired companies
• Ensure compliance with applicable legal/regulatory requirements (e.g., HIPAA, state/regional requirements)
• Maintain knowledge of information/process changes due to healthcare reform, referring to applicable company resources (e.g., dependent age, removal of lifetime limits, free preventive care services, Medical Loss Ratio)
• Demonstrate knowledge of established workflows and support processes (e.g., available resources, internal/external business partners, points of contact)
• Demonstrate knowledge of relevant internal processes impacting caller issues (e.g., claims processing, auto-adjudication)
• Identify inaccurate/inconsistent information found in systems/tools, and communicate to appropriate resources (e.g., IBAAG, SOP, AYS, SPDs, policies/procedures)
• Apply knowledge of applicable Service Level Agreements (SLAs) and Performance Guarantees when interacting with callers
• Maintain ongoing communications with callers during the resolution process to communicate status updates and other required information
• Maintain focus on caller interactions without being distracted by other factors (e.g., system usage, pop-up alerts, VCC data)
• Acknowledge and demonstrate empathy/sympathy with callers' life events (e.g., wedding, birth of baby, loss of relative, recent illness)
• Manage caller conversations appropriately (e.g., provide a good first impression, command attention and respect, maintain professional tone, demonstrate confidence, de-escalate/defuse callers as needed)
• Demonstrate understanding of internal/external factors that may drive caller questions/issues (e.g., recent plan changes, mass mailings, call directing/rerouting, weather emergencies)
• Ask appropriate questions and listen actively to identify underlying questions/issues (e.g., root cause analysis)
• Gather appropriate data/information and perform initial investigation to determine scope and depth of question/issue
• Identify and coordinate internal resources across multiple departments to address client situations, and escalate to appropriate resources as needed
• Proactively contact external resources as needed to address caller questions/issues (e.g., providers, labs, brokers)
• Utilize appropriate knowledge resources to drive resolution of applicable questions/issues (e.g., websites, CRM tools, Onyx, Siebel, knowledge bases, product manuals, SharePoint)
• Identify and communicate steps/solutions to caller questions/issues, using appropriate problem-solving skills and established guidelines, where available (e.g., workarounds, descriptions of relevant processes)
• Offer additional options to provide solutions/positive outcomes for callers (e.g., online access to relevant information, additional plan benefits, workarounds for prescription delays)
• Make outbound calls to resolve caller questions/issues (e.g., to callers, providers, brokers, pharmacies)
• Drive resolution of caller questions/issues on the first call whenever possible (e.g., first-call resolution, one-and-done)
• Ensure proper documentation of caller questions/issues (e.g., research conducted, steps required, final resolution)

• *Requirements**

• High School Diploma OR GED
• 2+ years of claims and / OR provider contracting experience
• 2+ years of customer response / customer service experience
• Ability to work our normal business hours of 9:30am – 6:00pm CST
• Ability to successfully complete the Customer Service training during hours of 8:00am – 4:00pm CST, Monday – Friday, and demonstrate proficiency of the material
• Must be 18 years of age OR older

• *Telecommuting Requirements**

• Reside within 30 miles of the following office location: 4770 Regent Blvd., Irving, TX 75063
• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

• *Soft Skills**

• Ability to multitask

• *What We Offer**

• Competitive salary
• Comprehensive benefits package
• Career development opportunities
• Diverse and inclusive work environment
• Recognition and rewards for performance
• Opportunities for growth and advancement

• *How to Apply**

If you are a motivated and customer-focused individual who is passionate about delivering exceptional experiences, we encourage you to apply for this exciting opportunity. Please submit your application today and join our team at careerzynith.

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