Description

Job Summary:  

The Client Experience Coordinator drives customer loyalty and satisfaction by managing the end-to-end customer journey, resolving complex inquiries, and analyzing work items to improve service. This role acts as the voice of the customer, collaborating with leadership and internally implementing strategies to ensure a seamless, positive experience. Responsibilities will include but are not limited to responding to inquiries, working with internal departments, processing claims adjustments, handling sensitive member interactions as well as identifying and helping to resolve trends. 

Duties and Responsibilities:

• Work escalations/disputes received from clients, Account Managers, members and our internal/external business partners. Work can be received via email, fax, paper, phone call, mailbox or from a queue of escalation/inquires (CRM).
• Investigate and resolve disputes/escalations. Research and identify root causes of denials/ underpayments and other errors and gather what is needed to resolve the issues. Identify the reason for the escalation.
• Provide best-in-class resolution through varied communication channels; resolve issues promptly, professionally and accurately within prescribed turn-around-time.
• Communicate with providers, customers, and other parties to gather information, provide updates and resolve escalations and inquires. 
• Update and maintain accurate records of progress, action taken, pending items and status; communicate updates to internal and external stakeholders.
• Collect and analyze data and feedback to identify pain points, process inefficiencies, gaps in support documentation, root causes of issues, and opportunities for improvement. Propose solutions.
• Support the design and execution of customer experience programs to improve service quality, efficiency, and brand perception.
• Monitor key performance indicators (KPIs), prepare reports on customer feedback, and maintain/update CRM tools to track and document interactions.
• Provide feedback for training opportunities, compile documentation as needed for retraining.  
• Regularly support call queues.
• Meet or exceed performance metrics including quality, accuracy, call handling time, time to resolution, work volume and member satisfaction; standards may be revised.

Requirements

Required Knowledge, Skills, and Abilities:

• High school graduate or equivalent
• 1+ years of experience in a customer service or call center environment handling escalation/2nd tier inquires preferably in a healthcare, insurance or TPA environment.  
• Comfortable supporting multiple channels and adjusting to dynamic workloads
• Familiarity with call center metrics and quality standards; Experience with claims processing, benefits, eligibility systems preferred
• Experience with CRM systems or customer support platforms preferred
• Experience in working escalations through emails and spreadsheets meeting timely resolution 
• Previous exposure to workforce management or scheduling tools
• Solid working knowledge of standard computer applications including MS Word, Excel, Outlook, and PowerPoint
• Ability using a computer which includes expert keyboard and navigation skills and learning new programs
• Communicate clearly and professionally with internal and external customers
• Work effectively individually and as part of a team to achieve established outcomes. Understand other’s roles and empower one another to take responsibility to be successful.  
• Demonstrate collaborative interactions with peers to reach a common goal as well as be a resource to team members and internal/external customers
• Pay close attention to detail in all aspects of the job
• Make decisions using available resources and sound judgment 
• Maintain confidentiality and discretion
• Identify and resolve problems in a timely manner, gather and analyze information skillfully and proactively
• Share knowledge with associates by effectively communicating and providing follow-up
• Open to other’s ideas and exhibits a willingness to try new things.
• Demonstrate accuracy and thoroughness; monitor work to ensure quality.
• Prioritize and plan work activities to use time efficiently.
• Adapt to changes in the work environment, manage competing demands and is able to deal with frequent changes, delays, or unexpected events.
• Follows instructions, responds to direction, and solicits feedback to improve.
• Act in such a way to instill trust from management, other associates, as well as customers.  
• Work overtime as required

Physical and Cognitive Demands: The demands described here are representative of those necessary for an employee to successfully perform the essential functions of this job. Reasonable accommodation can be made to enable individuals with disabilities to perform the essential functions.

• Constant: Talk, hear, speak, and use hands and fingers to operate a computer, telephone, keyboard/mouse; occasionally move about the office
• Constant: Visual ability such as close vision, distance vision, color and peripheral vision, depth perception and ability to adjust focus
• Occasional: Lift and/or move up to 10 pounds
• Constant: Regular, predictable attendance in the office is required
• Constant: While performing the duties of this job, the employee is regularly sitting for the full shift.
• Constant: The cognitive skills needed to complete tasks include abilities such as learning, remembering, focusing, categorizing, and integrating information for decision making, problem-solving, and comprehending. 

Work Environment: The work environment described is representative of what must be met by an employee successfully to perform the essential functions of this job.  

• The physical environment is indoors in a controlled climate, office setting. The noise level may be low to moderate.

The duties described are representative, but not restrictive of tasks that may be assigned or of the abilities required to do the job. The description is subject to change at any time. Other related duties may be assigned. This description does not alter the at-will status of employment.