Job Summary:

We are seeking an experienced Call Center Representative with a background in handling medical insurance. The ideal candidate will have excellent communication skills, a strong understanding of medical insurance processes, and the ability to provide exceptional customer service in a fast-paced environment.

Key Responsibilities:

• Handle inbound and outbound calls related to medical insurance inquiries, claims, and billing.
• Assist patients, providers, and insurance companies with questions regarding insurance coverage, benefits, and eligibility.
• Process insurance claims, authorizations, and referrals accurately and efficiently.
• Resolve customer complaints and issues with professionalism and empathy.
• Maintain detailed and accurate records of customer interactions and transactions in the database.
• Provide information and guidance on insurance policies, procedures, and regulations.
• Collaborate with other departments to ensure seamless customer service and issue resolution.
• Stay up-to-date with changes in insurance policies and procedures to provide accurate information to customers.

Qualifications:

• Must have 1 year or more of experience in a medical insurance call center environment. Specifically, a candidate who has worked for Aetna, Blue Cross Blue Shield, UHC, Kaiser, or any other medical insurance plan.
• High school diploma or equivalent; Associate's or Bachelor's degree preferred.
• Minimum of 2 years of experience in a call center or customer service role, with a focus on medical insurance.
• Strong knowledge of medical insurance terminology, processes, and regulations.
• Excellent verbal and written communication skills.
• Proficiency in using customer service software and databases.
• Ability to multitask and manage time effectively in a fast-paced environment.
• Strong problem-solving skills and attention to detail.
• Ability to work independently and as part of a team.
• Bilingual skills (preferred but not required).