Customer Complaint Representative
$14.00 per hour $15 Bilingual Spanish
Monday through Friday 8:00 AM to 4:30 PM
- Manage, coordinate and communicate with health plans and internal departments regarding escalated complaints.
- Contact clients in a timely and professional manner to deliver contract required information.
- Review and complete annual health plan audits with strict deadlines.
- Analyze and review policies for application towards internal correspondence and annual audits.
- Maintain working relationships with internal departments as well as external client contacts using a high level of both written and oral communication.
- Meet deadlines, working within tight time constraints.
- Correspond with management staff regarding customer service complaints including the gathering of data for problem resolution.
- Monitor and track via excel and/or other computer software tools the type and quantity of escalated complaints.
- Gather information necessary to respond to escalating complaints and/or grievances that extend beyond normal channels: complaints on appeal, legislative inquires and issues that meet the organization’s significant event policy.
- Produce internal reports on complaints and participant in monthly Quality Assurance meetings.
- High School Diploma or GED required.
- Associates or Bachelor Degree preferred.
- Lead or Quality Assurance experience preferred.
- Healthcare experience preferred.
- Ability to deal with complex problems involving a broad scope of issues while under pressure.
- Ability to effectively solve customer complaints in a timely manner by utilizing all tools available.
Other i.e. knowledge and skills:
- Must be proficient with Microsoft Office applications.
- Must type 40 wpm.
- Must have effective oral, written and interpersonal communication skills.
- Convey thoughts in a well-organized, concise manner. Use appropriate grammar and punctuation in written documents.