Essential Duties and Responsibilities:

• Provide knowledgeable responses to telephone inquiries in a courteous and professional 
manner, utilizing pre-scripted responses which they must read verbatim to provide basic  general and claims specific information
• Follow established and documented policies and standard operating procedures such as filling out timesheets, adhering to privacy rules and responding to numerous phone inquiries
• Utilize standard technology such as telephone, e-mail, and web browser to perform job duties
• Assist caller with filling out online application and submitting it electronically to plan provider for processing
• Complete basic call log related to the phone inquiries such as clicking radio buttons to confirm which scripts were read by the Customer Service Representative to the caller
• Refer calls as required to Customer Service Representative II
• Maintain up-to-date knowledge of CMS regulations and policies as they apply
• Report problems that occur via the online system so they can be addressed by the appropriate parties
• Respond to telephone inquiries within the set departmental staffing and time parameters 
• May be required to work scheduled holidays. Overtime may be required
• Regular and predictable attendance is required

• High School diploma or equivalent required
• Minimum six (6) months customer service experience required
• Ability to speak and read English and Spanish clearly, professionally and fluently
• Must be able to type a minimum of 20 WPM
• Ability to effectively work within established contractual turnaround times required
• Must have demonstrated excellent interpersonal and the ability to organize simultaneous tasks 
• Proven ability to work as a member of a team
• All CMS personnel will be required by contract to undergo program update training as the program changes