Are you looking to make a meaningful impact in the healthcare industry while enjoying great benefits and a supportive team environment?
CSTS Customer Service and Technology Solutions, LLC ("CSTS") is a fast-growing third-party administrator for Medicare Advantage health plans, headquartered in Spring Hill, Florida. Our team works with Medicare/Medicaid health plans and other government state agencies to perform critical business functions on behalf of their health care programs.
At CSTS, we believe in empowering our employees to deliver exceptional service to our health plans' members and their families. We offer not only a variety of benefits but also exciting team-building activities and incentives that foster a collaborative and positive work culture. If you're passionate about healthcare, dedicated to customer service excellence, and thrive in a dynamic setting, we invite you to apply. Join us in shaping a healthier tomorrow while enjoying the rewards of a fulfilling career with us.
Hiring Remote in the following states -
- Maryland
- Georgia
- Tennessee
- South Carolina
- Virginia
- Texas
Position Summary: Increases customer satisfaction by providing professional and accurate responses to incoming inquiries, concerns, requests, and complaints regarding the network, plan benefits, eligibility, authorizations, plan guidelines, enrollment, programs, and processes, as well as claims and pharmacy issues. Customers include but are not limited to members, prospective members, providers, and agents. Shift flexibility is required to accommodate hours of operation (Monday – Sunday, 8 am – 8 pm), including occasional overtime and weekends during certain times of the year.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
- Understands and provides accurate information regarding Medicare Advantage products courteously and professionally.
- Asks appropriate questions and listens actively to customers to identify needs to resolve the inquires in a timely and professional manner.
- Conducts accurate research to resolve issues regarding Medicare Advantage products using appropriate systems and departments.
- Ensures first call resolution to resolve customer needs and concerns effectively.
- Adequately documents all calls/contacts in detail as required by Department standards clearly and concisely.
- Effectively translates healthcare-related jargon and processes into simple, step-by-step instructions customers can understand and act upon.
- Operates telephone ACD system.
- Attends all departmental meetings and training sessions.
- Reviews training/educational material and seeks clarification when needed.
- Acts as a liaison between the customers when appropriate.
- Maintains strict confidentiality of all sensitive information.
- Maintains compliance with all company policies and procedures.
- Refers unresolved issues to the next level and/or appropriate areas when necessary.
- Achieves and maintains acceptable performance levels according to the Call Center and Quality standards.
- Answers telephones and warm transfers to appropriate staff when needed.
- Utilizes documents using Microsoft Office and other applicable software, as designated by management.
- Performs general clerical duties to include but are not limited to: photocopying, faxing, mailing, and filing.
- Processes member material requests and performs other Customer Service related tasks and functions.
Education and/or Experience
High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.
Other Qualifications
Previous experience in Managed Care and Medicare preferred but not required. Type 45 wpm.
Job Type: Full-time
Pay: $16.60 - $18.36 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible schedule
- Health insurance
- On-the-job training
- Paid time off
- Vision insurance
- Work from home
Experience level:
Shift:
Weekly day range:
- Monday to Friday
- Rotating weekends
Work setting:
Experience:
- Call center: 1 year (Preferred)
Work Location: Remote