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2b8aa18124710ccb6c662287df4bf586

Customer Service Specialist

Wellplace Detroit, MI Part-Time
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  •  Customer Service Specialist shall ensure that all phone calls are answered and assessed for severity, in order to triage the call and provide the most appropriate services:
  • Answer all phone calls using the approved telephone answering script
  • Assessing the call for a crisis prior to placing any call on hold
  • Conducting warm transfers for any caller in crisis to a crisis counselor and resource at Protocol
  • Identifying and transferring/referring callers to appropriate community resources
  • Observing and adhering to all HIPAA and Recipients Rights policies and procedures
  • Providing consumer–oriented , professional, and compassionate service
  • Documenting all incoming telephone calls
  • Collecting demographic information on all calls received prior to referring or transferring.
  • Conducting warm transfers for any caller who needs a clinical assessment/screen to the Access Center Clinicians
  • Customer Service Specialists shall ensure all aspects of the Enrollment/Re-Enrollment process are conducted by:
  • Responding to inquiries that address enrollment and eligibility
  • Performing initial and enrollment changes according to The Detroit-Wayne Integrated Health Network criteria and guidelines and comply with the default MCPN assignment Protocol
  • Using the Detroit-Wayne Integrated Health Network  MH-WIN Database for eligibility determination, look-up, enrollment, and default MCPN assignment
  • Verifying consumer Wayne County residency
  • Assigning consumers to an MCPN via the Random or Preference request
  • Documenting all calls in MHWIN.
  • Documenting all ineligible or incomplete enrollments
  • Conducting monthly TDD/TTY tests
  • Ensuring all call logs and enrollment documentation are complete before the end of the work shift
  • Customer Service Specialists shall ensure that all aspects of the Consumer Complaint, Grievance, and Appeals Process are conducted by:
  • Documenting all compliments and complaints
  • Demonstrate an understanding of the different complaint management systems of the public mental health systems and the specific benefit plans.
  • Providing consumers with accurate information as to the grievance, appeal and local dispute resolution associated with their specific benefit plan.
  • Gathering information in regards to the complaint/grievance and completing appropriate documentation.
  • Notifying supervisor immediately of consumer complaints
  • Performing follow up calls and customer satisfaction as necessary
  • Customer Service Specialists shall ensure that all aspects of their position are conducted by:
  • Attending and /or completing monthly required trainings
  • Attending monthly staff meetings
  • Conducting themselves as professional members of a team and working together to assist colleagues and supervisors as needed
  • Completing all other assigned tasks as instructed


Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
 

Recommended skills

Clinical Works
Appeals
Customer Satisfaction
Dispute Resolution
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Job ID: 62339242fb4240c5b7f84c68ed212af5

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