Long Term Care Customer Service Representative I (...

Excited to grow your career?We value our talented employees, and strive to help employees grow professionally. If you think the open position you see is right for you, we encourage you to apply Job Description: Summary: This role will require coming into the Rochester, NY office. The LTC Customer Service Representative resolves customer inquiries via telephone, mail, fax, and email concerning, but not limited to, policy benefits, claim payments, benefit reductions and billing. The LTC Customer Service Representative provides service for customers and business partners while responding in a professional, efficient, and timely manner to resolve issues and enhance customer satisfaction. Essential Accountabilities: All Levels u2022 Provides service among the customers and business partners while responding in a professional, efficient, and timely manner to enhance customer satisfaction. Must exercise tact, patience, and professionalism always in responding to internal/external customers. u2022 Documents, researches, interprets, and responds to inquiries from internal and external customers, and business partners concerning our products, services, and policies in accordance with HIPAA and other legislative requirements. u2022 Utilizes appropriate resources to resolves customer inquiries accurately & efficiently, resulting in acceptable quality, and performance. u2022 Participates in meetings, training, and skill development to support career path and individual development plans. u2022 Identifies and follows through on issues impacting MedAmerica and customer experience. u2022 Develops effective internal working relationships for improved communication and collaboration. u2022 Shares ideas and solutions to improve processes, procedures, and systems. u2022 Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companiesu2019 mission and values, adhering to the Corporate Code of Conduct, and Leading to the Lifetime Way values and beliefs. u2022 Maintains high regard for customer privacy in accordance with the corporate privacy policies and procedures. u2022 Regular reliable attendance is expected and required. u2022 Performs other functions as assigned by management. Level II (in addition to Level I accountabilities): u2022 Handles moderately complex customer and agent calls, resolves issues with minimal supervision. u2022 Accurately interprets individual and group policies and procedures to provide clear and accurate information to customers. u2022 Consistently demonstrates the ability to meet and exceed service metrics. u2022 Provides support to peers and leadership with regular operational administrative work. Level III (in addition to Level II accountabilities): u2022 Handles complex customer and agent calls with limited supervision. u2022 Assists with complex projects assigned by leadership that require advanced problem-solving skills. u2022 Assists with training and mentors other team members in all areas of Customer Service and supports new hires and peer group. u2022 Executes assigned tasks timely and accurately and any subsequent follow up needed. u2022 Organizes and completes daily operational administrative work. u2022 Provides escalation support for level I & level II calls. Minimum Qualifications: NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities. Level I: u2022 High School diploma or GED. u2022 Customer service experience preferred. u2022 Knowledgeable in all aspects of Customer Service, including PC Network application, benefit interpretation, processing procedures, administrative support to agents and customer relations skills. u2022 Demonstrates willingness to adapt and be flexible to changes and business needs while taking ownership and accountability for issue identification and resolution. u2022 Ability to multi-task to efficiently resolve customer concerns, by actively listening to the customer, navigating screens on the computer, typing call documentation, and speaking to the customer simultaneously. u2022 Excellent computer skills, including the ability to navigate in a Windows environment. Skillful at working between multiple programs and applications at the same time. u2022 Adept at communicating effectively and diplomatically while working as a collaborative team member. u2022 Strong reasoning skills with the ability to troubleshoot and problem solve. u2022 Strong organizational skills and ability to prioritize, and work in fast paced environment and remain professional and focused under multiple pressures and demands. Level Il (in addition to Level I qualifications) u2022 Two (2) yearsu2019 experience in a level I Customer Service Representative role. u2022 Associates degree in Business Administration, Health Care Administration, Health Economics or related. In lieu of degree, minimum of three (3) year of outside customer service experience required. u2022 Ability to efficiently resolve complex & escalated issues with minimal direction. u2022 Advanced system and navigational skills. u2022 Advanced communication skills with the ability to effectively communicate across multiple channels. Level III (in addition to Level II qualifications) u2022 Two (2) yearsu2019 experience in a level II Customer Service Representative role u2022 Ability to multi-task and self-sufficient in resolving complex & escalated issues. Demonstrated ability to think globally and takes initiative to recognize opportunities within the team. u2022 Demonstrates comprehensive knowledge and understanding of all policies to act as a resource for Level I and Level II colleagues. u2022 Experience with training or mentoring colleagues. u2022 Self-directed with the ability to deliver job tasks and projects within a deadline. Physical Requirements: u2022 Work is completed in a normal office environment under fluorescent lighting. u2022 Ability to use a headset to listen to customer conversations required. u2022 Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time. In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer Compensation Range(s): Level I: Grade N2: Minimum $18.22 - Maximum $23.89 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the positionu2019s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. With about 4,000 employees, 31 counties, and serving the needs of over 1.5 million members, you can imagine the gamut of skills it takes to keep our organization growing and our members flourishing. As an internal job seeker, this means growth and development in many directions, divisions, and roles.Take a look at information regarding our hiring process here. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Created: 2025-12-04