Demo

Call Center Customer Service Representative

SpotlightStaff.com
Rockville, MD Full Time
POSTED ON 2/24/2025
AVAILABLE BEFORE 4/21/2025

Responsibilities:

  • To obtain and maintain a working knowledge of the multiple benefit schedules, as well as a clear understanding of the eligibility system, claim system, and the Reciprocity system (ERTS)
  • Respond timely and accurately to phone calls, e-mails, walk in participants, and correspondence by answering questions; explaining claim payments and claim denials; quote self-payment amounts; verify eligibility and/or benefits; research eligibility or claim issues; update eligibility with outside vendors
  • Document all phone calls in the Customer Service module
  • Perform various clerical duties (i.e., enter enrollment forms; process working spouse forms, process special fund claims; process disability claims, etc.).
  • Navigate and provide accurate information regarding the website
  • Monitor incoming calls and calls waiting via the call management system
  • Pick up and handle messages from Nightline
  • Work on special projects as requested by Management
  • Other duties as assigned

Required experience:

  • 2 years of call center experience in a medical billing or medical insurance call center environment, or 1 years of processing medical claims
  • Proficient in Microsoft Outlook & Word
  • Bachelor’s degree or equivalent experience required
  • Previous TPA or major insurance carrier experience strongly preferred, but not required
  • Excellent written & verbal communication skills.
  • Demonstrates ability to manage complex issues while maintaining a flexible, positive, and cooperative demeanor.
  • Responds promptly to operations leaders and stakeholders to facilitate informed decision-making.
  • Troubleshoot assigned issues, gather evidence and investigate all relevant information with participants, vendors, and internal departments to resolve the problem cooperatively and collaboratively.
  • Dependability – ensures timely arrival and consistent attendance to support the achievement of the team’s goals.

Job Type: Full-time

Pay: From $25.00 per hour

Expected hours: 40 per week

Shift:

  • Day shift

Work Location: In person

Salary : $25

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