• Participant Services Specialists receive inbound calls and provide non-clinical and first-tier technical support.
• Specialists will manage to a support email inbox to resolve any inquiries that come to the department via email.
• Specialists will routinely research and resolve non-development and non-clinical related member issues and provide follow-up with outbound telephone contact.
• Specialists will provide basic technical web support to resolve user errors.
• Specialists retrieve voicemails and return department- specific inquiries.
• Specialists retrieve and document member issue details, investigate, facilitate the escalation of issue resolution with open communication to their team lead.
• Specialists maintain familiarity w/ tools and systems applicable to their position.
• Specialists triage clinical inquiries to appropriate team for assistance.
• Specialists consistently and accurately document every member interaction.
• Specialists utilize grievance/complaint tracking system to ensure that each inquiry is accurately documented and resolved in a reasonable amount of time.
• Specialists utilize reports and data to recommend positive change for the member and organization.
• Other duties as assigned by the Director of Operational Excellence
• The essential functions listed represent the major duties of this role, additional duties may be assigned.