Customer Service Representative

CarynHealth is looking for customer service professionals to provide expertise and support to members, providers, and other healthcare advocates. Customer Service Representatives are responsible for providing direct phone-based customer interaction to answer and resolve a wide variety of inquiries related to CarynHealth's healthcare products and solutions. The ideal candidate will have a commitment to service and providing a best-in-class experience for all callers.

Primary Responsibilities:

• Respond to and resolve customer service inquiries and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility, claims and correspondence
• Assist customers in website navigation and self-service options for their health plan
• Own a problem through to resolution on behalf of a member in real time or through comprehensive and timely follow-up
• Escalate member and provider issues to appropriate team members, as defined by our procedures
• Provide education and status on previously submitted pre-authorizations or pre-determination requests
• Meet the performance goals established for the position in the areas of efficiency, call quality, customer satisfaction, first call resolution, and attendance
• Proficient problem-solving skills
• Proficient in translating healthcare-related terminology and complex processes into simple, step-by-step instructions customers can understand and act upon
• Flexibility to customize approach to meet all types of member communication styles and personalities
• Proficient conflict management skills to include ability to resolve issues and demonstrating personal resilience
• Ability to work without constant direction from management
• Basic tasks are completed without review by others

Minimum Qualifications:

• High School Diploma / GED
• 1 or more years of customer service experience within the healthcare industry
• Ability to successfully complete the company training program within the required timeframe
• Ability to work regularly scheduled shifts within hours of operation, where lunches and breaks are scheduled
• Flexibility to adjust daily schedule
• Work overtime and/or weekends, as needed

• 401(k)
• Health insurance
• Paid time off