Customer Service Coordinator (myNEXUS)
Company: Anthem, Inc
Location: Hacienda Heights
Posted on: January 10, 2022
SHIFT: Day Job
Your Talent. Our Vision. At myNEXUS, a proud member of the Anthem,
Inc. family of companies, it's a powerful combination. It's the
foundation upon which we're creating greater access to care for our
members, greater value for our customers and greater health for our
communities. Join us and together we will drive the future of
myNEXUS is a technology-driven, care and benefit management service
that enables individuals to live healthier lives in their homes.
Our proven clinical model connects individuals to intelligent care
delivering independence at lower costs. To maximize health
delivery, we consistently leverage our: Innovative Technologies,
Advanced Clinical Expertise, and Proprietary Network Engagement
Platform. We are continuously pioneering ways to optimize health
resources for our clients and their customers. Through our
proprietary network management and engagement programs, we realize
enhancements in quality, outcomes, and care effectiveness.
The Service Delivery Coordinator-Customer Service Focus is the
front line of the company. This person is responsible for answering
all incoming calls from our clients and customers, processing
referrals via phone, triaging and troubleshoot both internal and
external portal support concerns and making outbound calls to
follow up on documentation needed to process referrals. This person
is responsible for accurately documenting all calls and
periodically interacting with clinical staff and other team members
across the organization. This position requires excellent
communication, attention to detail, ability to work in a fast-paced
environment and interpersonal skills. A high level of
professionalism and problem-solving skills are a must. This person
may also be required to assist with other service delivery duties
if business need arise.
+ Answers the telephone and patient/provider requests in a timely
and polite manner.
+ Using discretion and independent judgment in handling patient or
physician complaints received, documents and forwards to
appropriate administrative staff.
+ Escalates abnormal issues to Team Lead or Manager, making
recommendations for resolution.
+ Communicates with patients, family, case managers and all other
customers in a kind and professional manner.
+ Gives accurate explanations and verbal reassurances to all
customers (both internally and externally).
+ Willing to assist with additional tasks and departments with in
+ Interacts professionally with all, including co-workers and other
+ Fosters communication among healthcare team on the behalf of the
+ Proficient with myNEXUS systems, operations processes, data
entry, and basic computer skills for generation of daily office
communication and record generation.
+ Communicates ideas for improvement to the supervisor.
+ Demonstrate proficiency in meeting and exceeding all required
departmental goals and objectives.
+ Reflects knowledge and judgment in decisions and actions within
the job description of the Service Delivery Coordinator-Customer
+ Accurately and timely troubleshoots portal concerns and troubles.
Communicates with various teams and departments to timely resolve
any external portal concerns.
+ Must be able to demonstrate team behavior and must be willing to
promote a team-oriented environment.
+ Maintains complete and accurate patient care records within
+ Completes all compliance related training and demonstrates
compliance on the job.
+ Adheres to dress code, appearance is neat and clean.
+ Completes annual education requirements.
+ Always maintains patient confidentiality as well as following all
PHI guidelines and requirements .
+ Reports to work on time and from breaks as scheduled, completes
work within designated time.
+ Follows all company policies related to time records and time off
+ Attends annual review and department in-services, as
+ Attends at staff meetings and one on one meetings as scheduled
and reads all staff meeting minutes and other written documents as
+ Represents the organization in a positive and professional
+ Actively participates in performance improvement and continuous
quality improvement (CQI/QA) activities and programs.
+ Complies with all organizational policies regarding ethical
+ Communicates and demonstrates the mission, ethics and goals of
the Company, as well as the department.
+ Responsible for processing incoming and outstanding fax
processing and assigning to the appropriate myNEXUS team member
when business needs arise.
+ Takes part in redefining the customer service process to meet the
ever-changing needs of customers.
+ Able to deescalate situations in a professional and polite
+ Demonstrates high level customer service skills, both internally
+ Manages workload, ability to self-direct tasks and able to
delegate tasks and work appropriately and timely. Maintains
expected call handle times, average speed of answer, time available
in the phone queue and other expected metrics so myNEXUS meets
+ Accepts additional assignments willingly.
+ Supports the Mission and the Core Values of myNEXUS.
+ Performs other duties as assigned.
+ Shows proficiency with computer programs which may include
Microsoft Word, Excel, PowerPoint, Outlook and others.
+ Strong administrative, clerical and organizational skills.
+ Excellent customer service and follow-up skills.
+ Strong attention to detail and accuracy.
+ Ability to respond to common inquiries or complaints from
providers, patients or family members.
+ Must demonstrate the willingness to work in a team environment
and be a team player.
+ Possesses the ability to adjust to constantly changing work flows
Education and Experience:
+ 1-2 Years of phone customer service and/or call center experience
+ High School diploma or the equivalent.
+ Ability to read and communicate effectively in English.
+ Additional languages preferred.
+ Must understand and communicate effectively with providers and
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work
For , is ranked as one of the 2020 World's Most Admired Companies
among health insurers by Fortune magazine, and a 2020 America's
Best Employers for Diversity by Forbes. To learn more about our
company and apply, please visit us at careers.antheminc.com. An
Equal Opportunity Employer/Disability/Veteran. Anthem promotes the
delivery of services in a culturally competent manner and considers
cultural competency when evaluating applicants for all Anthem
Keywords: Anthem, Inc, Hacienda Heights , Customer Service Coordinator (myNEXUS), Other , Hacienda Heights, California
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