What are the responsibilities and job description for the Customer Service Representative position at SpotlightStaff.com?
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:
- 1 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 $20.00 per hour
Shift:
- Day shift
- Morning shift
Work Location: In person
Salary : $20
