What are the responsibilities and job description for the Claims/Customer Service Rep - Consumer Driven Services position at The Health Plan of West Virginia Inc?
The CDS Rep is responsible for all aspects of processing payment requests for all Consumer Driven Product lines as well as answering customer telephone calls and inquiries in a prompt and professional manner.
Required:
- High School graduate or equivalent.
- Motivated and works independently.
- Detail oriented with good problem solving skills.
- Ability to prioritize and meet deadlines.
- Proficient in basic math skills.
- Proficient in Microsoft Office products.
- Adaptable to changes.
Desired:
- Two (2) years experience in a call center environment.
- Familiar with insurance terminology.
- Knowledge of FSAs, HRAs and/or HSAs.
Requirements:
- Claims and/or calls workload management.
- Proficient use of necessary applications to perform various job functions.
- Establish adequate proficiency in claims and customer service processing systems.
- Meet requirements on annual performance evaluation.
- Consistently displays a positive attitude and acceptable attendance.
- Document calls according to departmental guidelines.
- Strategic in call de-escalation.
- Perform additional assigned tasks and complete them in a timely manner.
