Customer Service Specialist

2 weeks ago

Vienna, Virginia, United States Staffing Now Full time
Position Overview

As a Customer Service Specialist, you will deliver exceptional support to participants, local unions, providers, vendors, and fellow customer service representatives through various communication channels including telephone, email, and in-person interactions. Your role will involve providing empathetic and efficient service to ensure a positive experience for all.

Key Responsibilities

  • Develop and maintain a comprehensive understanding of the fundamental plan provisions and diverse benefit schedules, alongside a clear grasp of the eligibility and claims systems.
  • Respond promptly and accurately to inquiries via phone, email, and in-person, addressing questions, clarifying claim payments and denials, quoting self-payment amounts, verifying eligibility and benefits, and resolving eligibility or claim issues.
  • Document all interactions in the Customer Service module to maintain accurate records.
  • Perform various administrative tasks, including processing enrollment forms, managing working spouse forms, and handling special fund and disability claims.
  • Utilize effective navigation skills to provide precise information to all stakeholders.
  • Monitor incoming calls and manage call queues efficiently.
  • Handle messages from the nightline as required.

Qualifications and Skills

  • Minimum of 1 year of experience in a call center environment, preferably in medical billing or insurance.
  • Bilingual candidates are highly preferred.
  • A Bachelor's degree or equivalent experience is required.
  • Experience with a Third Party Administrator (TPA) or major insurance carrier is strongly preferred.
  • Excellent written and verbal communication skills are essential.
  • Proficiency in Microsoft Office applications is required.
  • Typing speed of at least 40 words per minute is necessary.
  • Ability to manage complex issues while maintaining a positive and cooperative attitude.
  • Timely responses to operations leaders and stakeholders to support informed decision-making.
  • Ability to troubleshoot issues, gather relevant information, and collaborate with participants, vendors, and internal departments to resolve problems effectively.
  • Dependability and consistent attendance are crucial to achieving team goals.
  • Must successfully complete required assessments in Microsoft Office, grammar, and customer service.
  • Ability to handle a high volume of calls efficiently.
  • Must be available to work on-site.
  • Commitment to a defined duration of employment is required.

Work Schedule:
Monday to Friday, 8 AM to 5 PM.

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