Customer Experience Associate- HMSA (Remote, must reside in Hawaii)

Job Description:

Customer advocate role supporting our members and providers, facilitating care and service. This is a service position providing assistance to Magellan's members, providers, and clients regarding various aspects of our programs, policies, and procedures. Responsibilities include handling incoming/outgoing calls related to healthcare related benefits. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall expectations are to provide outstanding service to internal and external customers and strive to resolve callers’ needs on the first call. Performance expectations are to meet and/or exceed customers’ expectations and our quality standards.

• Researches, articulately communicates medical information regarding a variety of services including: educating providers on claims, member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality/Protected Health Information (PHI.).
• Meets key performance indicators and service standards while showing compassion to members and providers per Magellan’s values and mission.
• Identifies and responds to crisis calls with appropriate resource.
• Facilitates routine referrals and triage decisions not requiring clinical judgment.
• Comprehensively assembles and enters patient information into the appropriate delivery system.
• Demonstrates flexibility in areas such as job duties and schedule to aid in better serving members and help Magellan achieve its business and operational goals.
• Supports team members and participate in activities to help build a high-performance team.
• Assumes full responsibility for self-development and career progression; proactively seek and participate in ongoing training sessions (formal and informal).
• Responsible for staying abreast of operational changes, updating self to ensure accuracy.
• Assists efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.
• Leads or participates in activities as requested that help improve Care Center performance, quality, and culture.
• Navigate Magellan’s systems, document customers' comments/information and forwards required information.
• Responsible for reading and retaining information disseminated through multiple resources, ensuring calls are addressed accurately and appropriately per account information.

1- 2 or more years of customer service experience.
Must be able to talk and type simultaneously, with attention to detail.
Must be flexible in scheduling and comfortable with change as customer service is an ever-changing environment.
Responsible for meeting monthly individual call center metrics.
Must agree to recording and evaluations for training and compliance.
Must be proficient with keyboard functions and navigation between multiple computer applications