Customer Service Representative

📋 Description

• • Serve as the first point of contact for healthcare providers nationwide, answering high-volume inbound calls and written inquiries regarding federal health programs with empathy, accuracy, and speed.
• • Research complex provider questions—ranging from claims status and prior authorizations to enrollment and policy clarifications—using multiple federal systems, internal knowledge bases, and cross-functional teams to deliver complete resolutions within service-level agreements.
• • Document every interaction in the client’s case-management platform with meticulous attention to detail, ensuring audit-ready records that support compliance, analytics, and continuous process improvement.
• • Prioritize and triage daily workloads using time-management best practices; generate daily, weekly, and monthly reports that highlight trends, bottlenecks, and opportunities for enhanced provider experience.
• • Identify recurring pain points and propose data-driven process enhancements; partner with leadership and quality assurance to pilot new workflows that reduce call volume, shorten resolution times, and elevate customer satisfaction scores.
• • Participate in agile, cross-training initiatives—rotating through special projects, system upgrades, and pilot programs—to broaden subject-matter expertise and keep pace with evolving federal regulations and technology stacks.
• • Model a culture of constructive feedback by coaching peers on effective communication techniques, sharing call-listening insights, and celebrating wins that reinforce a collaborative, inclusive remote environment.
• • Commit to lifelong learning: complete all mandatory compliance and skills training on schedule, exceed assessment benchmarks, and proactively pursue additional certifications (e.g., HIPAA, FHIR, CMS guidelines) to deepen healthcare domain knowledge.
• • Demonstrate situational leadership by stepping up as a subject-matter mentor during high-volume periods, leading huddles, and presenting best-practice findings to the wider team and client stakeholders.
• • Uphold the highest standards of data privacy, security, and ethical conduct in every interaction, safeguarding sensitive provider and patient information in accordance with federal mandates and TurningPoint policies.
• • Leverage Microsoft Office 365, Teams, and proprietary dashboards to collaborate seamlessly with remote colleagues, share real-time updates, and maintain a transparent, accountable workflow.
• • Contribute to a positive, resilient team culture that values diversity of thought, celebrates continuous improvement, and embraces change as an opportunity to deliver exceptional service to the healthcare provider community.