Medicare Advantage Support Specialist

This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13304216 The CSC MA Support Specialist will provide quality assurance, help desk and escalation desk support for Medicare Advantage operations. **What youll do**

• Assist CXRs with telephone and written customer inquiries. Research and identify solutions, coach in the moment to assist in de-escalating situations and handle escalated situations by resolving customer concerns. Track and trend inquiries received via the help and escalation desks. Directly assist with written and telephone customer inquiries when call center needs necessitate.
• Resolve problems and identify solutions for CXRs, follow appropriate department procedures, document the process and provide clear instructions on how to reach a resolution for future inquiries.
• Monitor live calls, written and email inquiries. Analyze and determine if course of action taken is accurate and within guidelines and departmental procedures. Provide evaluation of outcome and applicable feedback to direct supervision for future coaching opportunities.
• Research and make recommendations of correct information to avoid errors or omissions in our manuals/systems to include, but not limited to: Membership, Claims and Benefit resources and any systems and related research material.
• Same-day turnaround on all open inquiries to support meeting all departmental goals.
• Create and build samples to adequately represent a snapshot of a
  
  

CXRs skills to be quality checked.

• Utilize survey tracking system to identify action alert and unresolved inquiries, and check the inquiry to determine appropriate resolution.
• Operate in a close team environment. This includes the ability to mentor and serve as quality control or reviewer for other specialists and performing the duties of another team member during their absence. This also extends to assisting training with mentor and shadowing needs when applicable.
• Special projects or tasks as assigned.
• Meet department performance and quality standards of 99% accuracy and comply with corporate compliance program, security policies, standards and guidelines. **Knowledge/Skills/Abilities**
• Must be able to maintain confidentiality of the job and privacy of those inquiring. ```{=html}
  
  

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• In depth knowledge of Medicare Advantage contracts to include benefits, claims and enrollment to resolve issues frequently requiring determination of appropriate actions.
• Excellent reasoning, analytical skills, and sound judgment. Must act or think independently to develop a recommendation or resolution directly impacting escalated calls.
• Must demonstrate a strong commitment to providing accurate and quality customer service/interaction while working in a high stress environment and remaining timely, to allow for first call resolution.
• Advanced interpersonal and communication skills.
• Able to work collaboratively and cooperatively as a team member.
• Ability to work within a self-initiated environment with little supervision.
• Exceptional attendance. A successful candidate will be expected to maintain a consistent schedule with minimal unexpected absences.
• Strong computer skills and the ability to learn quickly and effectively utilize company systems and programs.
• Excellent attention to detail, prioritization and time management.
• Must be able to connect coaching elements to the BCBSKS Core Values.
• Must demonstrate a thorough understanding of the MA line of business and the appropriate customer service protocols. **Education and Experience:**
• High school diploma or equivalent.
• At least three years customer service experience required.
• E perience with coaching employees is preferred.
• Blue plan experience preferred.
• Medicare Advantage customer service and operations experience preferred.