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Customer Service Representative
4 months ago
Summary:
The primary responsibilities are to verify insurance coverage for potential and new clients. Additionally, this person will re-verify insurance coverage for existing patients to answer questions about benefits, coverage, billing and payments.
Effective delivery of company products and services
Responds to telephone inquiries from new policyholders, tenured policyholders, agents and their representatives
Provides information coverage and benefits, billing and payments and field general questions. Determines the best method for providing services.
Verifies insurance and/or payments
May perform data entry.
May assist with the processing of billing paperwork.
Accurately maintains files of all patient account profile information and referral source data.
Resolves patient complaints by identifying the root cause of opportunities and coordinating appropriate corrective action.
Knowledge of Medicare and 3rd party vendors is a plus.
Ability to demonstrate excellent customer services to members, agents and their representatives.
Must demonstrate strong attention to detail and proven analytic and problem solving.
This role will require an understanding of insurance concepts, including governmental plans, ancillary plan benefits, and other coverages.
Experience:
Knowledge of Medicare and 3rd party vendors is a plus.
Ability to demonstrate excellent customer services to members, agents and their representatives.
Must demonstrate strong attention to detail and proven analytic and problem solving.
This role will require an understanding of insurance concepts, including governmental plans, ancillary plan benefits, and other coverages.
Minimum of 1 year in a customer service or call center environment (call center type environments preferred, if doctor's office then anything below managing 75 calls/day would not translate to similar environment).
Must have effective and empathetic communication style in managing inbound calls and communications with clients and team members.
Computer experience is required with proficiency in Microsoft Outlook, Word and Excel.
Basic alpha number data entry skills with attention to accuracy and quality is essential.
Intermediate math skills are required with attention to detail and quality essential.
Experience in a health care setting or insurance industry is a plus, including knowledge of basic insurance and third-party terms and medical terminology.
Ability to work with people in a team environment while meeting individual performance goals.
Must be able to read and interpret policies, procedures and instructions.
Effective organizational skills and ability to prioritize a fluctuating workload and competing priorities is essential.
Education:
High School diploma or GED