What are the responsibilities and job description for the Customer Service Representative - REMOTE position at S'S Healthcare?
S&S Health is a premier healthcare administration company based in Cincinnati, Ohio. We specialize in offering self, level, and fully funded solutions designed to lower costs and enhance outcomes while providing a consumer-centric experience. Our comprehensive benefits, services, and technology platform are tailored to meet the needs of Employers, TPAs, and Health Systems. With a nationwide presence, S&S Health is equipped to sell and service clients across every state.
The Customer Services Representative plays a vital role in providing expert service to providers, members, and clients who have inquiries related to claims, eligibility, and benefits. This role involves promptly responding to customer concerns, resolving payment and adjudication questions, and clearly explaining claim calculation methodology, contract terms, and procedures. The representative will also support the call center team in ensuring high levels of customer satisfaction and first-call resolution. The position may offer shift flexibility with some mid-shift opportunities available.
Responsibilities :
- Customer Support : Field inquiries from providers and members via phone and email, helping them navigate the healthcare ecosystem and understand their claims and benefits.
- Claims and Payment Explanation : Provide clear communication regarding claims status, payment methodology, contract terms, and related procedures to ensure understanding from providers, members, and clients.
- Performance Metrics : Demonstrate a customer service focus with an understanding of key performance indicators such as average speed of answer, handle times, abandonment rates, and first-call resolution.
- Team Collaboration : Work with colleagues to investigate and resolve complex calls, ensuring timely and accurate responses.
- Documentation : Maintain accurate records of all interactions, ensuring compliance with company policies and procedures.
Qualifications :
S&S Health is committed to fostering a diverse and inclusive workplace. Please note that all final candidates will be subject to a comprehensive background check and drug testing as part of our hiring process.