Employer: Aflac
Job Summary
Responsible for providing expertise and critical escalation support to the call center teams, members, customers, and/or providers; intake escalated cases via: phone, email, system ticket, and in person requests from Aflac Dental and Vision Leadership; work any assigned case through to conclusion and ensure that all concerned parties are kept informed of the status and resolution of the case; responsible for routing complaints that are unable to resolved within the prescribed time frames into the grievance process
Principal Duties & Responsibilities
- Intake/triage escalation cases from the call center team. Determine priority and assign case to an ES team member
- Research escalated cases and work inter-departmentally to resolve the member’s complaint
- Data Entry Update member eligibility data as received by the Health Plan and internal Argus customers
- Research member account history, plan, payment options, complaints and other discrepancies; and correct as needed
- Research and respond to all escalated inquiries with a strong sense of urgency
- Special Projects Audit retrieve and assemble universes, Call Selections retrieve and analyze, Procedure audit assemble and review documents and P&P’s that support statues and Health Plan requirements
- Utilizes customer service strategies such as active listening, expressing empathy, problem solving, courtesy, and other skills deemed necessary
- Documents, tracks, and communicates issues appropriately using and accurately to deliver high quality customer service
- Serves as floor resource to support Customer Care Representatives
- Provide back-up to other units within the division as needed
- Other related duties as assigned
Education & Experience Required
- Minimum Required High School Diploma or Equivalent Qualification Level Experience
- Minimum Required Two or more years of customer service experience
Or an equivalent combination of education and experience.
Job Knowledge & Skills
- Ability to multi-task Ability to multi-task
- Ability to effectively perform in high volume environment
- Demonstrated interpersonal/verbal communication skills
- Written communication skills Strong verbal and written communication skills
- Ability to work independently and in a team setting
- Ability to handle distressed callers with patience and professionalism
- Expanded Word, Excel, Outlook
Competencies
- Acting with Integrity
- Communicating Effectively
- Pursuing Self-Development
- Serving Customers
- Supporting Change
- Supporting Organizational Goals
- Working with Diverse Populations
Working Conditions
The statements below describe the general nature and level of the work and are not an exhaustive list of all responsibilities, duties, and skills required.
Normal office environment (virtual or in-person)
Travel
None Required
