The Consumer Service Operations Representative 3 is responsible for the daily activities across multiple service functions area, including but not limited to mobile touch point locations in the various markets. The Consumer Service Operations Representative 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment.
Where you Come In
The Consumer Service Representative 3 will work alongside a Sales Manager in a specific market by making outbound calls and proactively managing potential member dissatisfaction. Representatives must document and track all interactions based upon CMS guidelines, participate in interdepartmental discussions and planning and assist the Enterprise Test and Learn Committee in measuring retention impact. The focus areas for membership retention are:
• Dual-SNP member
• Newly enrolled with Humana
• Broker/telesales/online enrollment, or an orphaned member
What Humana Offers
We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education.
Required Qualifications - What it takes to Succeed
• Fully Bilingual English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance. If selected for the position, you will be required to take a Language Proficiency Assessment in English/Spanish. See Additional Information on testing
• Minimum of 3 years of customer service experience, including typing/data entry
• Previous inbound and/or outbound call center or related customer service experience
• Proficient in Microsoft Office Outlook and Word
• Ability to work in the field, on-site in the Philadelphia area
• Excellent verbal, listening and written communication skills
• Aptitude for quickly learning and navigating new technology, systems and applications
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Associate's or Bachelor's Degree
• Previous healthcare experience
• 2 years of leadership, escalated calls, team lead or similar experience
• Clerical support background in a healthcare environment
• Familiarity with medical terminology and/or ICD-10 codes
• CNA or Medical Assistant background
• Quality background
• Medicare experience
Additional Information - How we Value You
• Benefits starting day 1 of employment
• Competitive 401k match
• Generous Paid Time Off accrual
• Tuition Reimbursement
• Parent Leave
• Go365 perks for well-being
Must have a separate room with a locked door that can be used as a home office to ensure you have absolute and continuous privacy while you work.
Must have accessibility to high speed DSL or cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana systems is 10M x 1M
Please be advised, Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Candidates must be tested in ALL languages listed on the description.
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a Modern Hire interview. In this interview, you will listen to a set of interview questions over your phone or text and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m, and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process.
Scheduled Weekly Hours