Customer Service Representative

Title: Customer Service Representative
Department: Call Center
Status: Non-Exempt ("hourly," overtime eligible)


Our Customer Service Representatives are often the primary contact many of our customers and participants have with P&A.  This means the Customer Service Representative role is key to our success as an organization.  The successful incumbent will actively demonstrate empathy, positive can-do behaviors with a keen desire to learn.  Under direct supervision, and utilizing the training received, the Customer Service Representative’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

  • Answer incoming calls, interpret caller’s question/problem and provide resolution; researching solution(s) using available software, systems and processes
  • Provide individual participants guidance and resources on plan terms/content and eligibility in compliance with applicable regulations
  • Strive for first call resolution for all inquiries
  • Maintain data protection, privacy, security and maintain HIPAA compliance for participants and clients
  • Follow up with participants or administrators via phone or email to resolve open issues
  • Be logged into phones and chat software and available to take chats at all times.  On chats always using excellent spelling and grammar
  • Assist less experienced representatives as appropriate
  • Proactivity:  Look for call trends and patterns and proactively escalate suggestions for system/process improvements to Management based on observations and participant feedback
  • Accountability:  Be ready to start work at scheduled start time; take responsibility for your workload and your own actions
  • Log all calls and chats in Flex Connect
  • Complete all required documentation
  • Performs all duties and responsibilities in a timely and effective manner in accordance with established department procedures
  • Keeps the Department Manager fully informed on all problems or unusual matters of significance and escalates when necessary
  • Takes direction from Customer Service Training Specialist, Customer Service Manager, Customer Service  Supervisor and Lead Night CSR and any/all company managers and supervisors
  • Follow communication procedures, respond using appropriate decision trees, guidelines and policies

Other Functions

  • Perform folding and stuffing for Group Insurance Department as needed
  • Pre-index claims that are in Onbase when time permits
  • Completes any additional assignments as requested by the executive/management team members
  • Provide mentoring/support of team
  • Position incumbent is required to use some independent judgment to understand and apply decisions related to departmental policies and procedures, and administrative practices 

Minimum Requirements

  • High School Diploma or equivalent 
  • Experience in a customer service/Call Center setting is a plus


  • Strong sense of accountability & initiative with a proven ability to see an issue through to resolution
  • Demonstrated ability to effectively manage multiple priorities utilizing effective organizational and time management practices
  • Self-starter with the ability to work independently in a fast-paced environment with critical deadlines
  • Solid oral and written communication skills with ability to convey one’s message with diplomacy and tact using proper grammar, sentence structure and spelling
  • Ability to effectively interact, present information, and respond to questions from customers, colleagues and management
  • Ability to interact with all levels of management and team members with professionalism
  • Strong attention to detail
  • Proficient in Word and Excel
  • Working knowledge of alternative support systems used within P&A Group