Customer Service Representative

1 month ago

Washington, Washington, D.C., United States Three Point Solutions Full time

Job Title: Member Service Representative I

Job Summary:

We are seeking a highly skilled and customer-focused Member Service Representative I to join our team at Three Point Solutions. As a key member of our customer service team, you will be responsible for providing exceptional service to our members, resolving issues, and ensuring a positive experience.

Key Responsibilities:

  • Answer member inquiries by researching and providing accurate information.
  • Resolve member service problems by exploring alternative solutions and escalating unresolved issues.
  • Examine claims to identify key elements and processing requirements.
  • Calculate deductibles, maximums, and resolve/report overpayments/underpayments.
  • Learn and execute enrollment transactions, generating accurate billing for policies and products.
  • Administer various billing transactions (direct pay, credit card, debit).
  • Identify clients needing managed care interventions and collaborate with clinical professionals to implement solutions.

Requirements:

  • High School Diploma or GED.
  • 1 year of customer service, claims experience, and inbound call center experience.

Preferred Qualifications:

  • Experience with detailed work, healthcare, health insurance, medical information, and direct service preferred.

Knowledge, Skills, and Abilities (KSAs):

  • Self-starter with strong organizational skills.
  • Effective interpersonal relationship skills.
  • Problem-solving abilities.
  • Excellent written and verbal communication.
  • Maintain quality customer service by following practices and responding to inquiries.

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