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Customer Service Representative

4 months ago


Bakersfield, United States Universal Healthcare MSO LLC Full time

Description:
The Customer Service Representative is tasked with handling incoming calls from various stakeholders, including health plan members, employers, providers, and health plans, regarding inquiries related to benefits, authorizations, claim resolution, and eligibility. They are responsible for assessing the purpose of each call and delivering accurate and relevant information to callers, even when dealing with complex inquiries.

**Compensation**:
**Job Duties and Responsibilities**:

- Handle telephone inquiries from members, employers, providers, and health plan coordinators.
- Project a professional and helpful demeanor to all callers.
- Maintain composure and professionalism when dealing with difficult or upset callers.
- Address caller needs promptly and effectively, either by helping or transferring the call to the appropriate party.
- Ensure calls are answered within an appropriate timeframe, including managing the number of rings, minimizing on-hold time, and reducing call abandonment.
- Provide accurate and thorough information consistently to callers.
- Utilize available resources to research and resolve moderately complex issues.
- Keep supervisor informed of any complex or significant issues that may impact other areas.
- Perform any other duties as assigned.

**Requirements**:
**Qualifications**:

- Proficiency in principles and processes for delivering excellent customer service.
- Familiarity with medical insurance, basic medical terminology, and experience in a managed care environment preferred.
- Strong organizational skills with the ability to manage multiple priorities and projects effectively.
- Competence in using various general office equipment such as desktop computers, copy machines, scanners, facsimile machines, and telephone equipment safely and accurately.
- Typing speed of 45 words per minute or higher.
- Bilingual proficiency in English and Spanish preferred.