Lead Call Center Representative – Call Center

Advertising Title

Lead Call Center Representative – Call Center

Position Classification



Eastern Region, Health Services / 20-0014


State of Connecticut, Access Health Connecticut

Reports To

Supervisor – Call Center

Required Education

College degree required

Preferred Education

Required Experience

At least 6 months of experience working in a call center environment

Preferred Experience

Two or more years of human services experience working with the public in a call center environment; experience providing coaching / training in a work environment

Required Skills

Knowledge of the community to be served; excellent  verbal communication skills; satisfactory writing skills; beginner’s ability with MS Word and Excel; ability to follow directions; ability to interact courteously and effectively with a wide variety of people; ability to work well under pressure and perform multiple tasks

Preferred Skills

Advanced knowledge of MS Word and Excel; proven high level communication skills; excellent written communication skills;


Bilingual ability may be required in Spanish, Arabic, or Haitian Creole


  1. Respond to AHCT Call Center inquiries and complaints received by telephone, IVR, and web portal using applicable reference materials from the Knowledge Management System (KMS), Frequently Asked Questions, and other online resources to provide information as appropriate to resolve inquiries and complaints.

  2. Retrieve, review, verify, collect, record, or update customer contact information and data through the CRM.

  3. Assess customer inquiries and screen complaints to determine the correct course of action; contact customers to collect additional information as needed to resolve inquiries or complaints.

  4. Educate callers and unit staff about the Affordable Care Act, AHCT Call Center eligibility screening, application, inquiry, complaints, claims, exemptions, appeals and enrollment procedures, including Medicaid program benefits and policies; and provide information on initial eligibility determinations.

  5. Provide technical assistance and direct callers and unit staff through web portal plan comparison; provide information and assist with comparison-shopping and other self-service tools as appropriate.

  6. Handle inquiries escalated by Tier 1 and Tier 2 Call Center Representatives and transfers to  Brokers, AHCT, DSS Benefits Center, OHA, CID, and other consumer support resources as appropriate

  7. Escalate inquiries and complaints to State eligibility and enrollment specialists or a Tier 2 Call Center Supervisor as needed.

  8. Transfer calls to Tier 3 staff, the AHCT, OHA, and CID as appropriate.

  9. Process over the phone, AHCT applications, QHP enrollments, plan changes, and disenrollments and update the CRM.

  10. Record all inquiry and complaint resolution information in the CRM.

  11. Assist Brokers and Navigators with inquiries and eligibility and enrollment issues; and identify and handle priority requests as appropriate.

  12. Maintain up-to-date knowledge of all program information, policies and procedures, and other resources stored on the KMS and available through other online resources.

  13. Review periodic satisfaction survey reports for AHCT management and approve for posting.

  14. Receive annual alerts from EMS for re-enrollment; initiate re-enrollment; complete consumer interviews and request verification as needed; and process re-enrollment.

  15. Receive notifications/requests to change status, request needed verification, and process change.

  16. Remain courteous, helpful, and sensitive to consumer and staff needs at all time, remain unbiased, and maintain consumer confidentiality.

  17. Raise issues of concern and/or problems to the attention of the unit Supervisor or other applicable AHCT resources as appropriate.

  18. Direct callers to the customer satisfaction survey as appropriate.

  19. Assist the Call Center Manager and Supervisor(s) with selected duties.

  20. Maintains positive relationships with unit staff and management.

  21. Handle the duties and responsibilities of the unit Supervisor in her/his absence.

  22. Assists with training of new Call Center CCRs and refresher training for existing CCRs

  23. Design, develop, and implement special projects as assigned.

  24. Meets all standards established for this position as outlined in the attached performance criteria.

  25. Performs other duties as may be assigned by the Call Center Supervisor or Management.

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