Customer Service Representative/receptionist

3 weeks ago


Miami, United States Best Doctors Insurance Services Llc Full time

This position is the face of the office, ensuring quality customer service is delivered to all clients via telephone or face to face. The Customer Service Rep/Receptionist will provide a variety of both complex and routine administrative services across all disciplines including researching and answering all inquiries which include claims, products and benefits in a professional and concise manner.

**ESSENTIAL JOB DUTIES AND RESPONSIBILITIES**:

- Greet all visitors accordingly
- Logs, tracks, and processes appeals and grievances
- Handling and solving customer complaints regarding claims process and/or service which may be complex or long-standing and coordinating the solution with the participation of departments involved
- Present appeals cases to the commit tee assigned and preparing communication of resolution to clients and agents
- Contacts customers to gather information and communicate disposition of case
- Conducts pertinent research in order to evaluate, respond to, and close appeals in accordance with all established regulatory guidelines
- Entering payment information in the system and follow up on pending payments
- Develops relationships with all levels of clients and achieve positive reviews about service and responsiveness.
- Establishes productive, professional relationships with key administrative personnel in assigned agencies and agents providing training on claims guidelines, product information and portal system when necessary to ensure that the members experience Best Doctors’ highest standards of quality and care

**DESIRED MINIMUM QUALIFICATIONS**:

- Excellent oral and written communication skills
- Excellent Analytical skills
- Detail oriented
- Able to deliver excellent customer service, externally and internally.
- Able to work under pressure
- Able to react effectively and calmly to emergencies
- Computer literate with good keyboard skills.
- Complete Fluency in English, Spanish

**EDUCATION AND EXPERIENCE**:

- Associates Degree or higher
- 3+ years’ experience in Customer Service
- Familiar with standard concepts, practices, and procedures of Health Insurance
- Relies on experience and judgment to plan and accomplish goals

**NECESSARY KNOWLEDGE**:

- Excellent computer skills with proficiency in Microsoft Word, Excel, PowerPoint and Outlook.
- Experience working within healthcare industry and claims
- Experience working within a call center environment a plus


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