Customer Service Representative
hace 3 semanas
Job Summary
We are seeking a highly skilled Customer Service Representative to join our team at Cognizant Technology Solutions. As a Customer Service Representative, you will be responsible for providing exceptional customer service and support to our clients.
Key Responsibilities
- Provide highest level of customer satisfaction.
- Strive to understand and resolve issues/queries at the first instance.
- Maintain the business controls as per the requirement.
- Respond to data requests and generate client-specified reports in a timely manner.
- Articulate/communicate in a manner which is understood by clients/end-users.
- Efficiently process predefined number of claims/enrollment as assigned with highest level of accuracy as agreed upon by the client.
- Escalate issues received in different batches.
- Support the team to achieve the SLA and TAT associated with Correspondence, Payments, PIA, and Write-off.
- Deliver quality metrics as defined by customers.
- Make and answer calls to and from customers/end-users based on agreed time frames.
- Transfer calls involving next level of service to the appropriate department as per the given guidelines.
- Develop a complete understanding of the procedures.
- Complete transactions for data preparation, submissions, etc. as defined in SOP's.
- Adhere to audit compliance (SAS 70, SOX, Statutory Audit) of all processes as laid out in process documentation.
- Ensure process guidelines are followed and met as documented.
- Set productivity/quality benchmark.
- Adhere to shift handover processes.
- Raise process-related issues/concerns on time with process and team leads.
- Ensure to meet all statistical, financial, and TAT metrics.
- Stay updated with the process knowledge/changes refer to knowledge updates/repositories to effectively process transactions.
- Adhere to security practices set by the organization.
- Provide updates and submit reports related to own area of work.
- Complete transaction/calls volumes in queue within specified Turn-Around Time.
- Respond to data requests.
- Perform administrative duties which includes maintaining accurate records of information regarding received claims/treatment requests.
- Record data relating to production statistics, end-user-related notes, etc. as appropriate.
- Maintain confidentiality of all information, policies, and procedures as required by the Health Insurance Portability and Accountability Act (HIPAA) protocols.
- Raise process-related issues/concerns to team leads/manager.
- Adhere to federal, state, URAC, client-specified, and established best practices regarding utilization management.
- Adhere to program quality standards and maintain acceptable levels of performance, including but not limited to attendance, adherence to protocols, customer courtesy, and all other productivity and efficiency targets and objectives.
- Continuous contribution to process excellence/improvement.
- Participate in project and organization initiatives led by the Delivery leadership.
Requirements
- Graduate (exclusion: BE/BTech/MCA)
- Bachelor's degree in Nursing or any health science-related field (for Medical Management)
- High School Equiv. (for NA)
Preferred Qualifications
- Experience in customer service or related field.
- Knowledge of business processes and procedures.
- Excellent communication and interpersonal skills.
- Ability to work in a team environment.
- Ability to adapt to changing priorities and deadlines.
Working Conditions
- Work in a fast-paced environment.
- Work with multiple stakeholders, including clients, team members, and management.
- May require working overtime or flexible hours.
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