What are the responsibilities and job description for the Customer Service Representative - Coastal position at Montage Health?
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Job Description :
The Customer Service Representative is responsible for answering telephone inquiries and responding to correspondence from employer clients, members and providers regarding eligibility, claims status and benefit determinations.
Responsibilities
- Intake all customer (provider, member, and health plan) calls as they relate to inquiries and grievances.
- Explain health insurance benefits, policies and procedures to members and providers, i.e., claims submission, appeal process, medical review, documenting all communication.
- Investigate timely filing of provider claims.
- Serve as a point of contact and liaison for customers.
- Successfully implement dispute resolution.
- Provide proactive and event-related education to customers.
- Facilitate customer care as appropriate.
- Assure accurate and timely response to all customer inquiries.
- Log calls and document action plans.
- Successfully bring all issues to closure within appropriate timeframe.
- Proactively identify areas of improvement and provide feedback.
- Perform member and provider satisfaction surveys as appropriate.
- Provide support and coverage to interdepartmental staff as needed.
- Coordinate customer grievances with appropriate department.
- Develop strong partner relationship with customers.
- Perform other activities and functions as defined by the Claims Manager.
Position Requirements
Pay Rate : $23.00 an hour
Aspire Health Plan is an equal opportunity employer.
Assigned Work Hours :
8 : 00am - 5 : 00pm with a one hour meal period.
Position Type : Regular
Salary : $23
