Customer Service Representative job - Public Consulting Group - Augusta, ME
Scope of Work : Member Services Representatives are expected to answer member calls, based on assignment, and take all appropriate follow-up actions, including, but not limited to, enrollment, MaineCare covered services, and EPSDT referral, etc. Responsibilities : Educate and enroll members into the MaineCare managed care program; Provide Member Services to MaineCare members; Provide members with a non-biased presentation of all current managed care options to promote the maximum freedom of choices within the member’s geographical region; Assist members by telephone with the completion of enrollment forms and related documentation by establishing and implementing a culturally and linguistically appropriate approach to member services; Answer member questions regarding available providers, language services and special programs within each managed care option (currently only one), refer enrollees to their respective HMO (not done currently) or managed care provider as appropriate; Access, read, and interpret member data elements and enter updates to reflect member activities, choices, and transactions in QNXT; Know and learn all functions and screens related to QNXT, Workflow and HealthPAS; Refer members to other state programs outside of the MaineCare Managed Care or fee-for-service plans such as the Division of Maternal and Child Health, WIC, etc.; Provide benefits for members under 21, by answering related phone calls; sort, file, and enter information into the QNXT system regarding benefits for members under 21; Report all problems to the appropriate supervisors and recommend solutions; Understand and be able to use all other automated systems, including, but not limited to, tracking all incoming/outgoing contacts in the QNXT call tracking system, etc.; Work as a team member with all other Member Services staff; Attend staff meetings and provide daily updates to the Member Services Supervisor or Team Lead on activities; Other duties as necessary. Minimum Qualifications : High school degree or GED and experience involving customer service relations; Call Center experience; Computer skills; Knowledge of Microsoft Office programs; Ability to communicate effectively; Ability to maintain confidentiality; Ability to multi task in a fast paced environment; Experience in meeting deadlines and adhering to strict standards; Enthusiasm for work responsibilities; Knowledge of MaineCare (Medicaid) is desirable; Knowledge of the cultural and geographic make-up of the State of Maine is desirable; and Knowledge of French, and/ or other languages is desirable. EQUAL OPPORTUNITY POLICY STATEMENT 41 C.F.R. Section 60-741.44(a); 60-300.44(a) Public Consulting Group, Inc. complies with Section 503 of the Rehabilitation Act of 1973, as amended, which prohibits discrimination by Federal government contractors and subcontractors against individuals on the basis of disability and requires affirmative action on behalf of qualified individuals with disabilities. Public Consulting Group, Inc. also complies with the Vietnam Era Veterans Readjustment Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which prohibits employment discrimination against protected veterans by covered Federal contractors and subcontractors and requires each covered Federal contractor and subcontractor to take affirmative action to employ and advance in employment these veterans. If you have a disability or are a veteran covered by the program, please notify us by contacting a Human Resources representative. Submission of this information is voluntary, and your refusal to provide it will not cause you to be subjected to harassment, intimidation, threats, coercion, or discrimination because you engage or may engage in any of the following activities: Filing a complaint; Assisting or participating in an investigation, compliance evaluation, hearing, or any other activity related to the administration of Section 503 or VEVRAA or any other Federal, state, or local law requiring equal opportunity for individuals with disabilities or protected veterans; Opposing any act or practice made unlawful by Section 503 or VEVRAA or their implementing regulations or any other Federal, state, or local law requiring equal opportunity for protected veterans or individuals with disabilities; or Exercising any other right protected by VEVRAA or by Section 503 or their implementing regulations. EQUAL EMPLOYMENT OPPORTUNITY – AFFIRMATIVE ACTION POLICY Public Consulting Group, Inc. pledges full support to the Affirmative Action Program and policy of nondiscrimination and equal opportunity in compliance with Executive Order 11246, as amended, as well as applicable state and local laws, directives, and regulations. Public Consulting Group, Inc. recruits, hires, trains, and promotes persons in all job titles without regard to race, color, religion, national origin, gender, gender identity, age, sexual orientation, disability, or protected veteran status. We ensure that hiring and promotion decisions are in accord with equal employment opportunity principles by imposing only requirements that are job related and do not have an adverse impact, and that other employment decisions further the principle of equal employment opportunity. Public Consulting Group, Inc. ensures that all personnel actions such as compensation, benefits, company-sponsored training, education, tuition assistance, transfer, demotion, termination, layoff, return from layoff, and social and recreational programs are administered without regard to protected group status. Equal opportunity can only be achieved through demonstrated leadership and aggressive implementation of a viable Affirmative Action Program. Our Affirmative Action Program sets forth specific affirmative action and equal employment opportunity responsibilities of managers, supervisors, and all employees. It is incumbent that employees not discriminate in any policy, practice, or procedure on the basis of protected group status. All employees are expected to make every reasonable effort to carry out their Affirmative Action Program responsibilities in spirit, as well as in letter, to assure that equal opportunity is available to all. We further expect all employees to demonstrate sensitivity to, and respect for, all other employees and to demonstrate commitment to the Company’s equal employment opportunity and affirmative action objectives. Administrative responsibility for this vital Affirmative Action Program, including regular monitoring and periodic reporting to top management, is delegated to EO Administrator Public Consulting Group, Inc.. This program is available for review upon request by any applicant or employee by contacting the EO Administrator during regular business hours. _______________________________________________ William S. Mosakowski, President Public Consulting Group, LLC 3/24/14 |
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