Client Support Specialist

2 weeks ago


Wheeling, West Virginia, United States The Health Plan of West Virginia, Inc. Full time

Position Overview: The Client Support Specialist plays a crucial role in delivering exceptional service by managing incoming inquiries with professionalism and efficiency. This position is essential for ensuring that both Members and Providers receive accurate and timely information.

Key Responsibilities:

  1. Handle an average of 40-60 incoming calls daily, addressing inquiries and providing solutions.
  2. Maintain a manageable workload for pending tasks, ensuring timely follow-up.
  3. Process correspondence, faxes, and emails promptly to meet departmental standards.
  4. Achieve a monthly monitoring score of 90% accuracy or higher on established performance metrics.
  5. Demonstrate comprehensive knowledge of departmental policies and procedures.
  6. Work independently with minimal supervision while completing assigned tasks.
  7. Meet or exceed expectations on annual performance evaluations.
  8. Continuously improve performance and enhance job knowledge.
  9. Document all interactions in accordance with departmental guidelines.

Qualifications:

  1. High School Diploma or equivalent is required.
  2. Ability to connect with a diverse range of customers effectively.
  3. Strong verbal and written communication skills.
  4. Basic understanding of healthcare and insurance concepts.
  5. Proficient computer and keyboard skills.
  6. Effective use of the English language.
  7. Consistently maintains a positive demeanor.

Preferred Qualifications:

  1. 1-2 years of post-secondary education with a focus on healthcare.
  2. Previous experience in a call center environment.
  3. Familiarity with medical terminology.
  4. Understanding of CPT and ICD-10 coding.
  5. Knowledge of medical and hospital claims processes.


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