Call Center Representative- CT

Hours: M-F Must be able to work any shift between 7am-7pm

Job Description:

1. Respond to Exchange Call Center inquiries and complaints received by telephone, IVR, and web portal using applicable reference materials from the Knowledge Management System (KMS), Frequently Asked Questions, and other online resources to provide information as appropriate to resolve inquiries and complaints.
2. Retrieve, review, verify, collect, record, or update customer contact information and data through the CRM.
3. Assess customer inquiries and screen complaints to determine the correct course of action.
4. Educate callers about Exchange Call Center eligibility screening, application, inquiry, complaints, claims, appeals and enrollment procedures, including Medicaid program benefits and policies.
5. Direct callers through plan comparison on the web portal and assist with other self-service tools as appropriate.
6. Escalate inquiries or complaints as needed to a Tier 2 Call Center Representative and for transfer to Tier 3 staff, the Exchange, DSS Benefits Center, OHA, CID, and other consumer support resources as appropriate.
7. Process QHP enrollments, plan changes, and disenrollments and update the CRM.
8. Record all inquiry and complaint resolution information in the CRM.
9. Assist Brokers and Navigators with inquiries and eligibility and enrollment issues as appropriate.
10. Identify and handle priority requests as appropriate.
11. Maintain up-to-date knowledge of all program information, policies and procedures, and other resources stored on the KMS and available through other online resources.
12. Remain courteous, helpful, and sensitive to customer needs at all times.
13. Remain unbiased and maintain customer confidentiality.
14. Raise issues of concern and/or problems to the attention of a Tier 2 Call Center Representative or Tier 1 Call Center Supervisor.
15. Direct callers to the customer satisfaction survey as appropriate.
16. Meet all standards established for this position as outlined in performance criteria and perform other duties as may be assigned by management.
17. Meets all standards established for this position as outlined in the attached performance criteria.
18. Performs other duties as may be assigned by the Call Center Supervisor or Management.

• College degree preferred
• 1 year call center experience required
• Knowledge of the community to be served
• Effective communication skills
• Ability to follow directions
• Ability to interact courteously and effectively with a variety of people
• Ability to handle pressure and perform multiple tasks
• Preferred qualifications include two years of human services experience or experience dealing with the public