Position Overview
**Duties and Responsibilities**
+ Provides excellent quality customer service to our members and/or providers relating to all aspects of member/provider questions and issues such as eligibility, benefits, claims process, escalations, and product questions, etc. May include but is not limited to inbound/outbound calls/emails/chats, onsite/remote/virtual/field location, on behalf of CCO.
+ Meets/Exceeds all performance KPIs including but not limited to quality, productivity, and dependability
+ Follows established policies and procedures to ensure member and provider issues are addressed timely and accurately
+ Identifies and de-escalate situations where member/provider is upset and provides resolution for their issue. Initiates investigations as required, partnering with other assigned parties to participate in root cause analysis, takes proactive and/or corrective measures and/or recommends solutions and methods for process improvement and follow-up on outstanding cus...