Health Insurance Customer Service Representative

6 days ago


Rockville, United States ROCS Grad Staffing Full time

Job Summary:

We are seeking an experienced Health Insurance Customer Service Representative with a background in handling medical insurance at an insurance company. The ideal candidate will have excellent communication skills, a strong understanding of medical insurance processes, and the ability to provide exceptional customer service in a fast-paced environment.


Key Responsibilities:

  • Handle inbound and outbound calls related to medical insurance inquiries, claims, and billing.
  • Assist patients, providers, and insurance companies with questions regarding insurance coverage, benefits, and eligibility.
  • Process insurance claims, authorizations, and referrals accurately and efficiently.
  • Resolve customer complaints and issues with professionalism and empathy.
  • Maintain detailed and accurate records of customer interactions and transactions in the database.
  • Provide information and guidance on insurance policies, procedures, and regulations.
  • Collaborate with other departments to ensure seamless customer service and issue resolution.
  • Stay up-to-date with changes in insurance policies and procedures to provide accurate information to customers.


Qualifications:

  • Must have 1 year or more of experience in a medical insurance call center environment. Specifically, a candidate who has worked for Aetna, Blue Cross Blue Shield, UHC, Kaiser, or any other medical insurance plan.
  • High school diploma or equivalent; Associate's or Bachelor's degree preferred.
  • Minimum of 2 years of experience in a call center or customer service role, with a focus on medical insurance.
  • Strong knowledge of medical insurance terminology, processes, and regulations.
  • Excellent verbal and written communication skills.
  • Proficiency in using customer service software and databases.
  • Ability to multitask and manage time effectively in a fast-paced environment.
  • Strong problem-solving skills and attention to detail.
  • Ability to work independently and as part of a team.
  • Bilingual skills (preferred but not required).


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