Beneficiary Care Representative

Job Description This is a remote position. Follow- Up & Beneficiary Support Proactively reach out to signed beneficiaries to confirm receipt of their medical cards and assist with any initial setup or questions they may have. Address and answer any plan-related questions, providing clear and accurate information to beneficiaries. Maintain a detailed follow-up schedule to ensure timely communication and support for all assigned beneficiaries. Use active listening skills to understand the beneficiary’s needs and concerns, ensuring that all issues are addressed appropriately. Escalate any complex issues or potential cancellations to the appropriate department or process, following company guidelines. Task Management and Efficiency: Manage and prioritize a high volume of tasks, with the goal of closing an average of 1,000 tasks per month. Ensure that all tasks are completed accurately and within the required timeframes, maintaining a high standard of customer service. Utilize CRM and other task management tools effectively to track progress, manage follow-ups, and close tasks efficiently. Process Adherence and Compliance: Follow all assigned processes and company protocols when dealing with beneficiary inquiries, adjustments, or potential cancellations. Ensure compliance with regulatory requirements and company policies during all interactions with beneficiaries. Document all interactions and outcomes in the CRM system accurately, ensuring that records are up-to-date and complete. Customer Satisfaction and Retention: Strive to provide a positive experience for all beneficiaries, aiming to resolve their issues and meet their needs in a timely and satisfactory manner. Contribute to the retention of beneficiaries by offering solutions that align with their needs and preventing cancellations when possible. Monitor feedback and complaints, providing insights to management on common issues or areas for improvement. Reporting and Communication: Provide regular updates to supervisors or managers on the status of follow-up tasks, highlighting any challenges or successes. Participate in team meetings and training sessions to stay informed about any changes in processes, plans, or company policies. Collaborate with other team members to share knowledge, strategies, and best practices for handling beneficiary interactions. Requirements Adherence and Attendance Policy Shift Hours: The regular working hours for this position are from 9:00 AM CST to 6:00 PM mnl Time, Monday to Friday, with a maximum of one hour for breaks. Time-Off Requests: Requests for time off must be submitted at least 48 hours in advance, except in cases of emergencies or unexpected blackout periods. Sickness Reporting: Employees must report any sickness at least one hour before the start of their shift. Performance Metrics: Employees are expected to meet performance metrics, including closing an average of 1,000 tasks per month, maintaining a QA score of over 95%, and ensuring all tasks are completed within required timeframes. Attendance: Failure to adhere to the attendance policy, including three consecutive no-shows or five separate instances of unreported absences, may result in disciplinary action up to and including termination. Qualifications Experience in customer service, preferably in a call center or outbound customer support role. Strong communication skills, with the ability to provide clear and concise information. Excellent organizational skills and the ability to manage a high volume of tasks efficiently. Proficiency in CRM systems and task management tools. Ability to handle sensitive information with confidentiality and professionalism. Strong problem-solving skills and the ability to handle difficult situations with empathy and patience. Ability to work independently and as part of a team in a fast-paced environment.