Job Description

Job Description

CUSTOMER SERVICE REPRESENTATIVE - REMOTE

Responsibilities:

1. Answer inbound calls from providers and members regarding insurance benefits, eligibility and claims.
2. Collect relevant information and analyze problems using computerized systems for researching membership and policy information, claim records and other data.
3. Answer questions, provide information, and resolve issues in a professional and compassionate manner.
4. Use computerized system for documenting calls and outcomes for accurate tracking and analysis.
5. Develop and maintain positive customer relations and coordination with various functions within the company to ensure customer requests and questions are handled appropriately in a timely manner.

Required Qualifications:

1. High school diploma or GED (or higher)

2. Up to one year of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.) using phones and computers and the primary job tools.

3. General PC knowledge including Microsoft Office (including the ability to navigate and learn new computer system applications)

4. Strong verbal, written and interpersonal communication and problem-solving skills.

Preferred Qualifications:

1. Prior healthcare/health insurance experience
2. Medical terminology and medical claims coding knowledge.
3. Healthcare claims adjudication and/or health care customer service experience

NOTE: We are currently training and working in a work at home environment , and you will be required to have reliable internet connectivity provided through a wired connection. A mobile or hot spot environment is not acceptable. You must live in a location that can leverage an existing high speed internet service. In addition, you are required to have a dedicated work area that is separated from other living areas and provides information privacy.