Customer Service Representative II

Jenkins Township, PA 18640

Posted: 08/27/2018 Industry: CSR Job Number: 3337380
Provides clerical and administrative support for the Eligibility Appeals Operations Support Project. Individuals in this job title perform one or more of the job functions described below.

Contact Center Unit:

Manages inbound calls regarding inquiries, approximately 90% request from appellant or representative regarding status of request, clarification of EDN.

Depending on inquire, may require escalation to Marketplace. If required, process transfer of call to Marketplace.

Limited positions require bilingual (Spanish speaking) skills

Adjudication Unit:

Place outbound calls to complete a checklist (Request for an Expedited Appeal checklist) to determine if appeals meets the requirement for an expedited appeal (72 hour requirement).

If information attained does not meet expedited requirements, generate status form letter to appellant.

Communicate to appellant regarding acceptance of expedited appeals and or inform appellant of decision.

Read Informal Resolution letter to appellant (per CMS request).

Hearing Unit:

Accept inbound calls regarding status of hearings, date/ need to reschedule, reminder notice of hearing date, overflow of calls from Contact Center.

Prepare hearing template / package in the required CMS order for Hearing Officer and align all attachments including the factual summary from

Adjudication department.

Set up the Hearing by logging into ready talk, greeting the appellant approximately 15 minutes earlier; set up the recording, listen and take notes, ultimately attaching the recording to the case file.O If during the meeting, the HO orders a change in circumstance, the admin employee will reach out to contact the Marketplace to connect them.

If appellant or we unable MP, the call in information is provided to appetent.

May perform other functions as requested by management within scope of level or occasional support of lower level functions as business/ volume needs require
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