Faneuil, Inc. logo

Customer Service Rep BCBSM

About the Employer
  • Faneuil, Inc.

Job Description



  • Internet Service - minimum of 10.0 mbps download and 10.0 mbps upload (no wireless or satellite connections)
  • A separate, distraction free work space within your home designed to improve your productivity

Faneuil is looking for empathetic, considerate, caring and enthusiastic Customer Service Representatives (CSR) to deliver excellent customer care and create sustainable value for customers.

The CSR will investigate, process, resolve, and respond to member, provider or beneficiary inquiries received via multiple contact methods regarding benefits, eligibility, materials forms, ID cards, PCP changes, complex inquiries and quality care issues. CSRs will direct and/or adjudicate claim-related inquiries. They will initiate status reports or service recovery letters to the inquirer when delays occur in responding to an inquiry as required. Rerouting misdirected inquires, educating new and existing members, providers, or beneficiaries concerning company policies and procedures and specific benefits through welcome calls and daily telephone inquiries and written correspondence are routine activities for a CSR.

Training Schedule: The training schedule will be Monday through Friday 5:00AM-1:30PM for 5 weeks.

On-job training (OJT) Schedule: The on-job training (OJT) schedule will be 5:30 AM PST - 2:00 PM PST, Monday thru Friday for 2 weeks.

Hours of operation : The hours of operations of the Call Center are Monday through Friday 5:00AM - 5:00PM and Saturday 7:00AM to 1:00PM, although extended hours may be required in accordance with needs of the business. These extended hours may include mornings, evenings, and/or weekends.

Essential Job Functions:

• Provides efficient and effective service to customers and prospects on all patron based services to a variety of inquiries and customer needs.

• Actively listen to customers, investigate and resolve member inquiries through correspondence and research.

• Create a caring and comfortable atmosphere for the customer.

• Maintains sincere interest in providing stellar customer care.

• Understands customer needs, determines the appropriate course of action to meet those needs and completes or initiates the transaction.

• Exercises independent thinking in meeting customer expectations.

• Combines knowledge of product, good work ethic, effective time management skills, and human relations skills to meet performance standards and positively influence the client's image.

• Ability to process information quickly and accurately.

• Ability to handle routine customer transactions.

• Ability to work under time constraints.

• Ability to understand and apply new concepts.

• Ability to analyze information and evaluate results.

• Ability to effectively deal with complex customers.

• Ability to create positive customer relationships by defusing angry and upset customers.

• Demonstrates a commitment to learning quickly and effectively applying knowledge as well as supporting/creating a productive, positive work environment.

• Attention to detail-documentation and follow-up.

Minimum Requirements

Experience Required:

• High school diploma or GED

• Minimum of 6 months call center experience or at least 1 year of customer service experience

• Knowledge of mainframe and computer (pc) and internet applications

• Microsoft Office applications

• Excellent telephone tact and diplomacy

• Excellent written, verbal and interpersonal communication skills with supervisors, peers, and customers

• Proficiency in keyboarding/data entry

• Exceptional oral and written communication skills demonstrated by use of correct grammar and terminology

• Time management skills (dependable, accurate, and detail oriented)

• Successful completion of Drug Screen and Background check

• Ability to work the hours of operations as shifts will not be assigned until the end of training

• Ability to attend 100% of the required weeks of training

Preferred Qualifications:
  • Associate's Degree or two (2) years of full time college credits
  • Two (2) years of customer service experience with personal contact reference
  • Experience in medical claims reimbursements or medical billing
  • Conversant in HMO/Health insurance industry terminology

Final candidates for this position will need to successfully complete a background investigation.

Faneuil, Inc.
Customer Service Rep BCBSM