Customer Service Representative

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 $25.00 per hour

Expected hours: 40 per week

Shift:

• Day shift

Work Location: In person

Salary : $25