Call Center Account Representative

At Chesterfield Companies, we are committed to excellence, innovation, and delivering top-tier solutions in Risk Management & Benefit Administration. We believe in fostering a collaborative and dynamic work environment where our employees can thrive and make a real impact. If you're looking for a career that challenges you, supports your growth, and allows you to be part of a passionate team, we want to hear from you!

SUMMARY: This position is responsible for managing all incoming telephone calls and general correspondence received from members of our Client’s health plan and the providers who render treatment to these members.

DUTIES AND RESPONSIBILITIES:

• Provides quality and professional customer service to members and providers, including use of proper telephone etiquette.
• Responds to all communications received in a timely and professional manner.
• Educates members and providers about healthcare benefits.
• Resolves claim issues or concerns that may arise, including the following:
• Initiates requests for stop payments, re-issues, and/or check forgery.
• Initiates recalculation requests after verifying that benefits were incorrectly paid.
• Initiates pricing requests with the network when necessary.
• Forwards additional information to Claims Examiners for claims reprocessing when necessary.
• Researches entire file to ensure that all issues are addressed.
• Ensures follow-up on all claims issues that need resolution.
• Brings issues to the Supervisor’s attention.
• Assists new CSRs with taking calls by shadowing.
• Assists as a backup the Provider Maintenance Specialist by accurately maintaining the integrity of our provider records and updating as needed.
• Provides backup in other areas, based on business needs.
• Assists as a backup all dental fax backs to provider.
• Assists as a backup for all faxes received by Chesterfield Resources.
• Performs other related duties as assigned by management.

QUALIFICATIONS:

• High school diploma or general education degree (GED), or one to three months related experience and/or training, or equivalent combination of education and experience.
• Previous experience in a call center or customer service role is preferred, but not required
• Certificates, licenses and registrations required: None
• Computer skills required: Microsoft Office Suite
• Other skills required:
• Demonstrate a positive and cooperative work attitude, encourage teamwork among fellow employees and customers.
• Must be able to communicate effectively with clients, claimants and professionals.
• Must be proficient in Windows operating systems, or equivalent, and have basic computer skills including data entry.
• Must be organized, have the ability to multi-task, work independently and problem solve.

Position Hours: Monday - Friday 8 a.m. to 5 p.m.

**This role is in office**

If you are a motivated individual with a passion for customer service and enjoy working in a dynamic team environment, apply now to join our call center team!

Job Type: Full-time

Pay: $15.00 - $16.00 per hour

Benefits:

• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Vision insurance

Compensation Package:

• Bonus opportunities

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Application Question(s):

• How many months/years of Call Center experience do you have?

Experience:

• Insurance verification: 1 year (Preferred)

Ability to Commute:

• Uniontown, OH 44685 (Required)

Work Location: In person

Salary : $15 - $16