Customer Service Representative I

4 weeks ago


Franklin, United States Integrated Resources Full time

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description Job Title : Customer Service Representative 1 Duration : 31 weeks (Temp to Hire) Location : Franklin TN 37067 Responsibilities : Handles customer service inquiries and problems via telephone, internet or written correspondence. Customer inquiries are of basic and routine nature. Our call center is open from 7 am to 8 pm Central Time. They could have an eight hour shift that falls within our business hours. Answers questions and resolves issues based on phone calls/letters from members, providers, and brokers. Triages resulting rework to appropriate staff. Documents and tracks contacts with members, providers and brokers. Explains member's policy benefits and coordination with Medicare. Handles complaints (member/provider), via relevant recording/reporting system. Ensures compliance with requirements of regional compliance authority/Medicare. Determines applicable coverage provisions and verifies member plan eligibility. Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. Performs financial data analysis as necessary. Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received. Adheres to international privacy policies, practices and procedures. Requirements: CSR must be able to read from a script. CSR must be able to type 30-35 WPM. CSR's should have at least a year of Medicaid/Medicare experience. CSR must have Call Center/Contact Center background. #J-18808-Ljbffr



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