Job Description
Job Description
Description :
As a Lifestyle Manager, you will be responsible for conducting risk assessments for patients enrolled in the Medicare program to validate their needs and lifestyle. You will play a key role in the service experience by providing professionalism, courtesy, and excellence.
Essential Functions :
- Communicate with members by phone to provide information about their respective health insurance plan services.
- Offer guidance, support, and educational services on non-clinical matters related to different plan coverages and promotions.
- Manage calls and refer them to the appropriate resources based on the specific needs of the member.
- Document and record transactions, including details of inquiries and actions taken.
- Escalate unresolved customer complaints to the supervisor or designated departments for further investigation.
- Provide support on other Contact Center projects.
- Conduct telephone interviews (outbound calls) with members regarding services, satisfaction levels, and follow-up activities.
- Participate in training and development sessions.
- Ensure confidentiality and compliance with all applicable state and federal regulations for Health Call Centers, including HIPAA and internal policies for handling confidential information.
- Immediately notify the supervisor of any exposure to Protected Health Information.
- Comply with core and functional training as well as all procedures established by regulatory agencies, contractual requirements, and applicable certification standards (including but not limited to URAC).
Requirements :
At least one (1) year of Customer Service experience.Completed high school diploma and / or college credits (preferred).Advanced knowledge of computer applications and / or Microsoft Office.Strong customer service orientation and commitment.Excellent verbal and written communication skills.Fast documentation and internet navigation skills.Availability for shifts (including holidays), Monday to Friday from 8 : 00 AM – 6 : 00 PM.What are the benefits of joining our team as a Health Services Representative?
On-the-job training, regulatory aspects, and health-related education.24 / 7 telemedicine service.Free health and wellness programs for employees.Opportunities for growth and development.Contribute to the health and well-being of the community.Job Type : Full-time
Work Location : On-site job in Guaynabo, PR
EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER (EEOC)