Job Description

Please note this job posting is for future training classes; targeted start date is to be determined. All positions are hired as temporary employment and have the opportunity to go permanent based on employee performance and client need.

GENERAL SUMMARY:

The CMS Customer Service Representative is responsible for delivering general healthcare information to callers. Customer Service Representatives are expected to work their assigned schedule and to be ready and available to take related healthcare calls; as business requirements dictate. The Customer Service Representatives use basic office equipment and technology such as telephones; email; and web browsers to perform their duties. The processes that the Customer Service Representatives must follow are well defined and documented in standard operating procedures and scripts. Prescribed scripts must be read verbatim to the caller. Neither subject matter knowledge nor independent decision making is required by this position.

The Customer Service Representative I reports directly to the Customer Service Supervisor. This is an entry level position responsible for disseminating healthcare information. When taking calls; application processing; enrollment guidelines and a general healthcare background will be the focus with callers. When taking other healthcare calls; disenrollment; social security mailings and a general background will be the focus with callers. The Customer Service Representative I will follow scripting when taking either calls to determine when to transfer the caller to a Customer Service Representative II.

JOB RESPONSIBILITIES:

• Provide knowledgeable responses to telephone inquiries in a courteous and professional manner; utilizing pre-scripted responses which they must read verbatim to provide basic general and claims specific information.
• Follow established and documented policies and standard operating procedures such as filling out timesheets; adhering to privacy rules and responding to numerous phone inquiries.
• Utilize standard technology such as telephone; e-mail; and web browser to perform job duties.
• Be ready and available to take both Medicare and Marketplace calls; as business needs dictate; on short notice.
• Follow directions via email; Leadership; or other means regarding the switching back and forth from one type of call to the other.
• Successfully complete ongoing healthcare training requirements; including but not limited to Part A Claims; Part B Claims; and DME Tier 1; as business needs dictate.
• Assist caller with filling out online application and submitting it electronically to plan provider for processing.
• Complete basic call log related to the phone inquiries such as clicking radio buttons to confirm which scripts were read by the Customer Service Representative to the caller.
• Refer calls as required to Customer Service Representative II.
• Maintain up-to-date knowledge of CMS regulations and policies as they apply to both the healthcare programs by completing all assigned training (CUP; EJT; Desk to Desk; etc.)
• Report problems that occur via the online system so they can be addressed by the appropriate parties.
• Respond to telephone inquiries within the set departmental staffing and time parameters.
• May be required to work GDIT scheduled holidays. Overtime may be required.
• Perform other related duties as assigned.
• Regular and predictable attendance is required.

Education

• High School diploma or equivalent required

Qualifications

EXPERIENCE:

• Minimum 6 months customer service experience required.
• Must be able to speak and read English clearly; professionally and fluently.
• Must be able to type a minimum of 20 WPM.
• Ability to effectively work within established contractual turnaround times required.
• Must have demonstrated excellent interpersonal and the ability to organize simultaneous tasks.
• Proven ability to work as a member of a team.
• All CMS personnel will be required by contract to undergo program update training as the program changes.

WORKING CONDITIONS:

The work is typically performed in an office environment; which requires proper safety and security precautions. To ensure our contact center production area is at minimal risk for unauthorized disclosure (that is; the release or divulgence of information by an entity to persons or organizations outside of that entity) of Personally Identifiable Information (PII) or Protected Health Information (PHI); the work environment operates under a Secure Floor Policy. The Secure Floor Policy limits or restricts personal belongings; electronic devices; or paper that can be brought into production areas.

The above job description is not intended to be; nor should it be construed as; exhaustive of all responsibilities; skills; efforts; or working conditions associated with this job. Requests for reasonable accommodations will be considered to enable individuals with disabilities to perform the principal (essential) functions of this job. General Dynamics Information Technology is an Equal Opportunity/Affirmative Action Employer.

As a trusted systems integrator for more than 50 years, General Dynamics Information Technology provides information technology (IT), systems engineering, professional services and simulation and training to customers in the defense, federal civilian government, health, homeland security, intelligence, state and local government and commercial sectors.With approximately 32,000 professionals worldwide, the company delivers IT enterprise solutions, manages large-scale, mission-critical IT programs and provides mission support services.GDIT is an Equal Opportunity/Affirmative Action Employer - Minorities/Females/Protected Veterans/Individuals with Disabilities.