CGS Customer Advocate - Kentucky

Peckham Inc. - CGS Customer Advocate

SUMMARY

Under close supervision, as a Peckham, Inc. Customer Service Advocate, the Tier 1 Customer Service Representative accepts and responds to phone inquiries from Medicare and Medicaid providers.

DUTIES AND RESPONSIBILITIES

• Maintain an understanding of the processing procedures to respond to numerous phone inquiries.

• Gather information to determine customers’ needs and apply problem solving skills to resolve the inquiry/request effectively.

• Respond to telephone inquiries within the set departmental staffing and time parameters.

• Complete Tier I phone calls meeting both CGS and CMS timeliness and quality standards:

  • Professionally answer provider Tier 1 calls while maintaining standard handle times < 433 seconds.

  • Maintain 93% Quality Audit Measure (QAM) on external vendor audits.

  • Maintain 93% quality standard for Privacy, Knowledge, and Customer Skills on in-house audits.

  • Complete callbacks within 10 days

  • Timesheets to be completed daily within CGS’s Deltek timekeeping system.

• Adhere to the Privacy Act as it relates to the confidentiality of information released.

• Continually look for and suggest process improvements which will benefit Peckham and our customers (internal and external).

• Maintain up-to-date knowledge of CMS regulations and policies as they apply.

• Report problems that occur and assist with the resolution.

• Utilize databases and written materials to look up and provide information to telephone inquiries.

• Maintain appropriate documentation of phone inquiries.

• Assist with the delivery of internal employee training for new and temporary employees as requested.

• Follow protocol and apply sensitivity and discretion in handling confidential information.

• Must be sensitive to cultural diversity and able to work with people from various backgrounds.

• May be required to work Peckham scheduled holidays.  Overtime may be required.

• Other related duties as assigned.

MINIMUM QUALIFICATIONS

•     At least 18 years old.

•     High School Diploma or equivalent.

•     Proficient in the English language (written and verbal).

•     U.S. Citizen.

•     Ability to pass a thorough background check screening (credit and criminal history) to determine fitness for a federal security clearance.

•     Successfully pass a 10-panel drug screen with a negative result.

•     Computer and keyboarding skills sufficient to record information from the inquirer in an accurate and efficient manner.

•     Ability to work independently without direct supervision.

•     Oral and written communication skills sufficient to facilitate clear and accurate information exchanges with customers.

•     A neat/quiet room/home office space designated for remote work that meets requirements.

•     A High-Speed Internet connection that meets minimum technical requirements of Uploads speed 5Mbps and Downloads 10 Mbps. Internet speed test required after interview.

•    High speed internet must be cable or DSL. Candidates will be required to provide internet provider information.

PREFERRED QUALIFICATIONS

•     Minimum of 6 months of Medicare and Medicaid contact center experience.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the individual will be required to multitask. The employee will also be required to speak, listen, read, and use a computer simultaneously during their scheduled shift. Individuals will be required to be mobile throughout the building. 

WORK ENVIRONMENT

Individuals will be required to work well independently, however will also be a member of a team and therefore must be able to work in a team atmosphere.  The tasks of the call center are repetitive in nature.  The noise level is generally moderate.  The work environment characteristics described are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Individuals will be on the phone from their remote office for most of their scheduled shift. Peckham will provide a computer, monitor and headset and the employee will provide workspace and internet connectivity that meets minimum requirements.

SECURITY

Many of the positions through the Business Services Division require security clearance. Thus, the candidate/employee must pass and maintain appropriate security and background checks as required for each area and/or contract. The extent of the security and background check may vary by position. Employment may also be contingent upon successful security and background checks and may be run on an ad hoc basis. Required security and clearance checks will be completed at no financial cost to the candidate.

OTHER INFORMATION

This job description in no way states or implies all duties to be performed by the employee occupying this position. Employees will be required to follow any other job-related instructions and to perform other job-related duties requested by their supervisor in compliance with Federal and State Laws.

Peckham is an Equal Opportunity Employer - EEO/AA Employer/Vet/Disabled.  Peckham provides equal opportunities and does not unlawfully discriminate on the basis of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, genetic information, height, weight, marital status, veteran status, or any other protected characteristic protected by applicable federal, state, or local law. EEO is Law

EOE-Embracing Diversity to Achieve Excellence

SPECIAL NOTES

These jobs are part of the AbilityOne program, to learn more about the AbilityOne program go to www.abilityone.gov

PECKHAM IS AN EQUAL OPPORTUNITY EMPLOYER

EEO/AA Employer/Vet/Disabled.  Peckham provides equal opportunities and does not unlawfully discriminate on the basis of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, genetic information, height, weight, marital status, veteran status, or any other protected characteristic protected by applicable federal, state, or local law.

REASONABLE ACCOMMODATION FOR APPLYING NOTICE

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance or a reasonable accommodation to complete any part of your application please:

• Click HERE and you will be directed to the ILRU Directory to find an agency in your area that can assist you
• Click HERE and you will be directed to the American Jobs Center (AJC) finder to locate a center near you
• Email us at jobs@peckham.org
• Call us at (517) 316-4000
• Visit us at: 3510 Capital City BLVD, Lansing, MI 48906 (M-F 8am - 4pm)

Examples of reasonable accommodations may include making a change to the application process, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.

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