Claims Customer Service Representative
1 day ago
Job Summary
The Benefits and Claims Customer Service Representative provides critical support to hospitals, providers, and participants by delivering accurate and timely information on health and welfare benefits and claim status. This role requires exceptional customer service skills, attention to detail, and the ability to navigate complex benefit plans.
Key Responsibilities
- Customer Service
- Provide high-quality customer service to all Fund members by documenting telephone, written, and walk-in inquiries regarding benefits or claim status in an efficient, prompt, and professional manner.
- Respond to and resolve complex issues, including those escalated by members.
- Serve as the primary daily contact to clients on the delivery of services.
- Resolve complex plan provision questions and issues addressed.
- Raise issues as appropriate to the Team Supervisor or Department Manager.
- Learn and use professional excellence tools and concepts to ensure efficient and quality output/service delivery.
- Teamwork
- Work cooperatively with other team members.
- Actively participate in team meetings and training activities.
- Perform additional responsibilities and projects as periodically assigned.
Requirements
- Education/Certification:
- (Minimum) High School Diploma/GED
- Skills/Abilities:
- Minimum 40 WPM and 3,000 KPH proficiency
- Prior experience in a medical setting (doctor's billing office, hospital billing, etc.) is helpful.
- Knowledge of medical terminology preferred.
- Ability to maintain current knowledge of plan benefits to provide correct information to plan participants and providers.
- Professional, client-focused approach to colleagues and assignments.
- Strong oral and written communication skills with exceptional attention to detail.
- Ability to seek out experiences that may change perspective or provide an opportunity to learn new things.
- Strong dedication to follow-through on all tasks and assignments.
- Ability to sit for long periods of time operating a computer keyboard.
- Ability to speak, read, and write in both English and Spanish preferred.
Employee Benefits Program
- COMPANY PROVIDES Healthcare benefits including MEDICAL, DENTAL ($1,500 per year, $1,000 per year for Plan B), VISION, SHORT-TERM DISABILITY benefits for a low weekly premium of $5 (Employee Only), $15 (for Child(ren) and $20 per week for FULL FAMILY COVERAGE.
- COMPANY PAID supplemental dental coverage of $1,000 per year for Employee.
- COMPANY PAID LONG TERM Disability & Life/AD&D coverage.
- 401K Plan including company match up to 5%.
- COMPANY PAID additional pension plan entirely funded by the company.
- EXCEPTIONAL TIME OFF package including Paid Personal Leave (PPL) and Vacation with annual BUY BACK options
- Annual, automatic pay increases.
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