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Customer Service Representative
2 months ago
Welcome to Montage Health’s application process
Job Description:
The Customer Service Representative is responsible for answering telephone inquiries and responding to correspondence from employer clients, members and providers regarding eligibility, claims status and benefit determinations.
Responsibilities
Intake all customer (provider, member and health plan) calls as they relate to inquiries and grievances.
Explain health insurance benefits, policies and procedures to members and providers, i.e., claims submission, appeal process, medical review, documenting all communication.
Investigate timely filing of provider claims.
Serve as a point of contact and liaison for customers.
Successfully implement dispute resolution.
Provide proactive and event-related education to customers.
Facilitate customer care as appropriate.
Assure accurate and timely response to all customer inquiries.
Log calls and document action plans.
Successfully bring all issues to closure within appropriate timeframe.
Proactively identify areas of improvement and provide feedback.
Perform member and provider satisfaction surveys as appropriate.
Provide support and coverage to interdepartmental staff as needed.
Coordinate customer grievances with appropriate department.
Develop strong partner relationship with customers.
Perform other activities and functions as defined by the Claims Manager.
Position Requirements
At least two years' experience in customer service/call center within the managed care, insurance, healthcare, or related call center environment
Strong comprehension skills
Ability to communicate effectively, including written and verbal communication skills
High level of attention to details in obtaining complete and accurate information
Problem resolution skills
Strong interpersonal and negotiation skills
Ability to key data accurately and rapidly
Basic knowledge of insurance terminology and medical coding, e.g. ICD and CPT
Ability to operate computer equipment and software programs necessary to fulfill position responsibilities
Working knowledge of Microsoft office products including Outlook, Word, and Excel
Ability to interact professionally with co-workers, providers, clients, brokers and management-level staff.
Excellent phone manner and ability to handle multiple phone lines.
Must be able to meet established deadlines
Aspire Health Plan is an equal opportunity employer.
Pay rate: 21.00-23.00
Assigned Work Hours:
Monday - Friday 8:30am to 5pm
Position Type:
Regular
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