Participant Support Specialist

Scope/Impact

The Participant Support Specialist role is key to our success as an organization. Under direct supervision, and utilizing the training received, the Participant Support Specialist’s function is to provide effective and accurate responses to our callers, using in-depth knowledge of the customer’s plan(s) and program(s) as well as communicating effectively with internal team members throughout the department and organization. Strong proactive problem-solving and troubleshooting skills are key components of this role.

Effective performance of all duties and responsibilities of the position will assure accurate and timely completion of required tasks and compliance with required timelines.

Essential Functions

• Receive incoming calls from participants and providers answering questions and solving problems efficiently and accurately to exceed customer’s service expectation.
• Receive incoming chats, always using excellent spelling and grammar.
• Follow up with participants or administrators to resolve any open issues.
• Be available on phones and/or chats at all times.
• Log all calls and chats in flex connect.
• Complete all documentation as needed, stop payments, ach reversals, CEC and claim adjustments.
• Log in and out of phone system when away from desk.
• Keeps the Department Manager fully informed on all problems or unusual matters of significance and escalates when necessary.
• Takes direction from the Participant Support Center managers, supervisors, and trainers and any/all company managers and supervisors.

Other Function(s)

• Champion P&A Group values and policies.
• Maintain data protection, privacy, security and maintain HIPAA compliance for participants and clients.
• Completes any additional assignments as requested by the executive/management team members
• Performs all duties and responsibilities in a timely and effective manner in accordance with established departmental procedures