Customer Service/Call Center Rep



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Branch Information

Honolulu, HI - (USA) 737 Bishop Street Suite 122 HI Honolulu , HI 96813

Branch Phone Number


Job Description


Serves as a liaison between the company, clients, members and providers. Provides professional, thorough, accurate, and timely customer service and responds to a high volume of primarily routine telephone and other inquiries to and from members, providers, employer groups, and clients; and documents inquiries

Essential Duties and Responsibilities

Responds and logs routine telephone inquiries from members, providers, employer groups, and clients. Inquiries require knowledge in the areas of utilizing the plan, benefits, eligibility, claims, premium payment, and accurate completion and processing of forms and documentation

Participates in training to develop skills and knowledge that will be utilized in performing essential duties

Remains current on all changes to customer service policies, procedures and product information for accurate resolution

Identifies specific questions, problems or concerns using clarifying questions and researching individual files

Effectively accesses, interprets and analyzes internal policies and information maintained on computer databases, in resource manuals, and in various computer systems to resolve inquiries

Accurately responds to and follows up on inquiries in a timely and professional manner that represents our company and clients favorably through verbal and written communication

Refers escalated cases to a specialist or management

Logs and tracks inquiries

Assists department until situations are resolved

Makes outbound phone calls as needed to resolve issues

Investigates problems and complaints, including reviewing responses from other departments and supervisors

Determines appropriate resolution, including negotiating positive outcomes

Identifies and notifies supervisors of client, member, and system issues or trends.

Suggests solutions, quality improvements, or procedural changes

Informs applicable departments of errors, including claims paid or denied in error, and requests adjustments or corrections


High school diploma or GED is required. College degree; three years of experience in customer service, call center or a related area; or an equivalent combination of experience and education is preferred



Excellent customer service, organizational, and verbal and written communication skills

Attention to detail, work independently and in a team environment with minimal supervision, and consistently meets deadlines

Strong listening and problem-solving skills

Positively, proactively, and accurately handle customer concerns and focus on multiple tasks simultaneously in a fast-paced call center environment

Take initiative to effectively execute and follow through

Achieve department performance metrics, including an average calls-logged ratio of 95% or higher

Basic-level proficiency in Microsoft Word, Excel, and Outlook


Experience with IE or similar web browser

Health care industry or related experience

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job

Air-conditioned professional office environment with a quiet to moderate noise level

If employee qualifies and Senior Management approves, may work remote with the understanding of set frequencies in the office