Customer Service Representative

2 days ago

Kuala Lumpur Centre Kuala Lumpur, Malaysia Cigna International Health Services Sdn Bhd Full time 12,000 - 30,000 per year

POSITION : Customer Service Representative

REPORTING TO     : Customer Service Supervisor or Manager

DEPARTMENT       : Customer Service

JOB PURPOSE

The job holder is responsible of effectively handling inquiries from customers, clients or providers received via phone and e-mail located domestically and internationally in "real time" contact center environment. He/She interacts appropriately and efficiently with health care professionals using excellent interpersonal and listening skills, critical thinking, and problem-solving skills.

RESPONSIBILITIES AND DUTIES

  • Receives requests by mail, telephone or in person regarding insurance claims/policies while operating on multiple computer applications.
  • Responds to inquiries from policy holders, providers and/or others for information and assistance.
  • Performs research to respond to inquiries and interprets policy provisions to determine most effective response.
  • Mails or routes claims forms and supporting documentation to various units for final processing.
  • Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity.
  • May seek assistance with complex customer services issues.
  • Understand and interprets policy provisions.
  • Performs research to respond to inquiries and interprets policy provisions to determine most effective response using established departmental procedures, HIPAA regulations, and corporate policies.
  • Uses computer-based resources in a highly effective manner to educate and provide accurate responses to inquiries is crucial for success.
  • Issue Emergency GOP (Guarantee of Payment) and COC (Certificate of Coverage) as required when it is necessary.
  • Collaborate with other stakeholders / teams to resolve queries including complex queries.
  • Actively support all team members to enable operational goals to be achieved.
  • Meet or exceed Service Level Agreement requirements, team KPI(s), monthly quality audit scores and NPS (Net Promoter Score).

KNOWLEDGE, SKILLS AND EXPERIENCE

  • Fluent in English - verbal, written, reading, Mandarin is an added advantage.
  • High School Diploma or equivalent required or Associate or bachelor's degree preferred.
  • 1+ years of customer service experience analyzing and solving customer problems required, call center experience a plus.
  • Intermediate proficiency in Microsoft Office Suite.
  • High level capacity to multitask independently and on a computer.
  • Knowledge of Medical Terminology a plus.
  • Excellent written and oral communication skills.
  • Ability to perform in a high volume, fast paced call center environment.
  • Proven ability to work independently as well as a productive member of a team.
  • Exceptional organizational and time-management focus.
  • Possess excellent attention to detail, with a high level of accuracy.
  • Strong interpersonal skill with good verbal and written communication, enjoy working and collaborating with team members.
  • Strong customer focus with the ability to identify and solve problems.
  • Flexible to work in shifts and on staggered weekends.

COMMUNICATION AND WORKING RELATIONSHIPS

The job holder develops effective relationships and communications with clients to ensure a working relationship.

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