Employer Service Rep

3 weeks ago

Wheeling, United States The Health Plan of West Virginia Inc Full time
Job DescriptionJob Description

The Employer Service Representative is responsible for answering telephone calls from client contacts in a prompt and courteous manner, resolving any client issues relating to claims and eligibility, and responding to written inquiries from clients. The ESR is responsible for keeping the Account Executive and management informed of any trends or issues identified.

The ESR will also be responsible for reviewing No Surprise Act (NSA) requests and responding in a timely manner. NSA responsibilities include, but are not limited to, negotiating on behalf of clients within given guidelines and keeping the client, Account Executive and direct management up to date on case progress and, preparing reporting for Executive Management to identify trends.

Required:

  1. High School graduate or equivalent.
  2. Self-starter and works independently.
  3. Detail oriented with good problem solving skills.
  4. Ability to prioritize and meet deadlines.
  5. Maintains confidentiality.
  6. Good communication skills.
  7. Proficient in Microsoft Office products (Word, Excel, Power Point).
  8. Easily adapts to changes in work requirements.

Desired:

  1. Bachelor’s degree from an accredited college or university.
  2. Previous experience in enrollment, claims processing or call center.
  3. Medical Terminology.
  4. Knowledge of CPT and ICD-9/ICD-10 coding.
  5. Knowledge of medical and hospital claims.
  6. Knowledge of prescription coding (NDC).

Responsibilities:

  1. Answer all calls and correspondence in a timely, professional and friendly manner.
  2. Resolves client issues.
  3. Works with operations team to have claims processed or adjusted as needed.
  4. Communicates with clients, members and providers as necessary to obtain information required to resolve issues.
  5. Records and tracks all information clearly and accurately.
  6. Activity report prepared and shared with management monthly.
  7. Understands benefits and copay detail in order to relay this information clearly and accurately.
  8. Understands claim detail, identifies claims issues and reports issues to management when necessary.
  9. Keep all member protected health information (PHI) confidential.


  • Solar Customer Service Rep

    2 weeks ago

    Wheeling, United States AGI Full time

    Description Solar Customer Service Rep - ONGOING PAID TRAINING We're seeking a positive, personable customer service representative for a rewarding career opportunity! You'll connect with new people, tackle tough problems, and raise the bar on an excellent customer experience. We welcome applicants who are interested in upward mobility, a positive work...

  • Solar Customer Service Rep

    2 weeks ago

    Wheeling, United States AGI Full time

    Solar Customer Service Rep - ONGOING PAID TRAINING We’re seeking a positive, personable customer service representative for a rewarding career opportunity! You’ll connect with new people, tackle tough problems, and raise the bar on an excellent customer experience. We welcome applicants who are interested in upward mobility, a positive work environment,...

  • Member Advocate

    3 weeks ago

    Wheeling, United States West Virginia Employer Full time

    Under the general direction of the Unit Manager or Unit Supervisor, the Clinical Services Member Advocate is responsible for completing outreach activities for member engagement into various programs as well as performing additional program, unit and interdepartmental support functions. The Member Advocate is responsible for coordinating administrative or...

  • Pre-Employment Transition Services Instructor

    4 weeks ago

    Wheeling, United States Russell Nesbitt Services Inc. Full time

    Job DescriptionJob DescriptionJob descriptionGENERAL DESCRIPTION:This contracted, part-time position will function as the instructor for all pre-employment transition services (Pre-ETS) and Life Skills programs as defined by WV Division of Rehabilitation Services. This position will teach the established curricula and adapt as necessary to meet the needs of...

  • Pre-Employment Transition Services Instructor

    3 weeks ago

    Wheeling, United States Russell Nesbitt Services Inc. Full time

    Job DescriptionJob DescriptionJob descriptionGENERAL DESCRIPTION:This contracted, part-time position will function as the instructor for all pre-employment transition services (Pre-ETS) and Life Skills programs as defined by WV Division of Rehabilitation Services. This position will teach the established curricula and adapt as necessary to meet the needs of...

  • Solar Customer Service Rep

    1 month ago

    Wheeling, United States AGI Full time

    Description We're seeking a positive, personable customer service representative for a rewarding career opportunity! You'll connect with new people, tackle tough problems, and raise the bar on an excellent customer experience. We welcome applicants who are interested in upward mobility, a positive work environment, and can't wait to get started!...

  • Solar Customer Service Rep

    3 weeks ago

    Wheeling, United States AGI Full time

    We’re seeking a positive, personable customer service representative for a rewarding career opportunity! You’ll connect with new people, tackle tough problems, and raise the bar on an excellent customer experience. We welcome applicants who are interested in upward mobility, a positive work environment, and can’t wait to get...

  • Line Service Technician

    4 weeks ago

    Wheeling, United States Hawthorne Global Aviation Services Full time

    Job DescriptionJob DescriptionSummaryAre you interested in Corporate Aviation? Do you enjoy working in a fast-paced environment and being part of a great team? We are looking for Line Service Technicians to start their aviation careers with us! Hawthorne Global Aviation Services is a world class aviation services company and leader in general aviation...

  • Line Service Technician

    3 weeks ago

    Wheeling, United States Hawthorne Global Aviation Services Full time

    Job DescriptionJob DescriptionSummaryAre you interested in Corporate Aviation? Do you enjoy working in a fast-paced environment and being part of a great team? We are looking for Line Service Technicians to start their aviation careers with us! Hawthorne Global Aviation Services is a world class aviation services company and leader in general aviation...

  • Sales Service Driver

    2 weeks ago

    Wheeling, United States Gordon Food Service Inc Full time

    Welcome to Gordon Food Service! We are excited that you are thinking about opportunities with us, and we have an amazing story to share. See below for a quick glance of who we are and the impact you could have on the food service industry. There's a seat at our table for you... **CDL A Delivery Driver** **Location**: 199 Shepard Ave, Wheeling, IL Do you...

  • Job Coach

    4 weeks ago

    Wheeling, United States Russell Nesbitt Services Inc. Full time

    Job DescriptionJob DescriptionJob CoachWe are looking for individuals who are enthusiastic and understand the gratification of helping individuals who need assistance in learning how to become a viable candidate for employment. No two days are the same and every day you have a chance to make a difference in someone's life.General Description:Carries out...

  • Job Coach

    3 weeks ago

    Wheeling, United States Russell Nesbitt Services Inc. Full time

    Job DescriptionJob DescriptionJob CoachWe are looking for individuals who are enthusiastic and understand the gratification of helping individuals who need assistance in learning how to become a viable candidate for employment. No two days are the same and every day you have a chance to make a difference in someone's life.General Description:Carries out...

  • Customer Service Representative

    4 weeks ago

    Wheeling, United States Wheeling Linen Service, Inc. Full time

    Job DescriptionJob DescriptionJOB DESCRIPTIONLooking for a stable company where you can make a difference? Career opportunity with growing, successful regional family owned and professionally managed company, servicing customers since 1934.Local business is looking for an inside Customer Service Representative. Candidate must be outgoing, dependable and...

  • Customer Service Representative

    7 days ago

    Wheeling, West Virginia, United States Wheeling Linen Service, Inc. Full time

    JOB DESCRIPTION Looking for a stable company where you can make a difference? Career opportunity with growing, successful regional family owned and professionally managed company, servicing customers since 1934. Local business is looking for an inside Customer Service Representative. Candidate must be outgoing, dependable and highly motivated individual who...

  • Customer Service Representative

    1 week ago

    Wheeling, United States Wheeling Linen Service, Inc. Full time

    JOB DESCRIPTION Looking for a stable company where you can make a difference? Career opportunity with growing, successful regional family owned and professionally managed company, servicing customers since 1934. Local business is looking for an inside Customer Service Representative. Candidate must be outgoing, dependable and highly motivated individual who...

  • Customer Service Representative

    3 weeks ago

    Wheeling, United States Wheeling Linen Service, Inc. Full time

    Job DescriptionJob DescriptionJOB DESCRIPTIONLooking for a stable company where you can make a difference? Career opportunity with growing, successful regional family owned and professionally managed company, servicing customers since 1934.Local business is looking for an inside Customer Service Representative. Candidate must be outgoing, dependable and...

  • Associate Contract Specialist

    1 month ago

    Wheeling, United States West Virginia Employer Full time

    West Virginia Employer Associate Contract Specialist Wheeling , West Virginia Apply Now Performs duties to support provider contracting initiatives in accordance with Corporates, Federal and State guidelines. Maintain and enhances the provider network to meet or exceed access quality and financial goals. Ensure contacts are sent and executes timely, loaded...

  • Associate Contract Specialist

    1 week ago

    Wheeling, West Virginia, United States West Virginia Employer Full time

    West Virginia Employer Associate Contract Specialist Wheeling , West Virginia Apply Now Performs duties to support provider contracting initiatives in accordance with Corporates, Federal and State guidelines. Maintain and enhances the provider network to meet or exceed access quality and financial goals. Ensure contacts are sent and executes timely, loaded...

  • Route Sales and Service Driver

    3 weeks ago

    Wheeling, United States Wheeling Linen Service, Inc. Full time

    Job DescriptionJob DescriptionRoute Sales/Service DriverMany companies in our industry service accounts that are not "ideal". They can be exceptionally dirty and not what you would want to handle.We paint a different picture at our company. We serve only the best and cleanest customers in the Restaurant, Hospitality, and Healthcare industries.You, as a Route...

  • Account Executive

    3 weeks ago

    Wheeling, United States West Virginia Employer Full time

    PREFERRED QUALIFICATIONS: Waste or service industry experience. MINIMUM QUALIFICATIONS: Bachelors Degree or 5 years relevant sales experience. (Required) Minimum of 2 years of direct selling experience in a customer-facing role that includes identifying and addressing customer needs. (Required) Valid drivers license. (Required) _ _ POSITION SUMMARY: The...