Medical Insurance Call Center Representative
3 weeks ago
We are seeking an experienced Medical Insurance Call Center Representative to join our team at Spherion. As a key member of our medical insurance department, you will utilize your medical knowledge to assist clients with their insurance inquiries, claims, and coverage, providing accurate and compassionate support.
Key Responsibilities- Respond to customer inquiries related to medical insurance coverage, benefits, claims, and billing, using your medical knowledge to provide accurate information.
- Assist clients in understanding their insurance policies, including coverage for specific medical procedures, treatments, and medications.
- Process and verify insurance claims, ensuring all information aligns with medical records and coding.
- Address and resolve customer issues, including discrepancies in claims or coverage, in a professional and empathetic manner.
- Educate customers on the claims process, eligibility, and benefits, leveraging your medical experience to explain complex medical terms and procedures.
- Document customer interactions and maintain accurate records in the system.
- Escalate complex or sensitive issues to the appropriate department or supervisor as needed.
- Stay updated on changes in medical insurance policies and procedures, as well as medical guidelines and terminology.
- Meet or exceed performance metrics, including call handling time, customer satisfaction, and accuracy.
- High school diploma or equivalent; additional education or certification in a medical-related field is highly preferred.
- Previous experience in a call center or customer service role within the medical insurance industry is required.
- Strong understanding of medical terminology, procedures, and coding.
- Excellent communication skills, with the ability to clearly explain medical and insurance information to customers.
- Proficient in using computer systems, including customer management software, medical billing systems, and Microsoft Office.
- Ability to multitask, prioritize, and manage time effectively in a fast-paced environment.
- Attention to detail and strong problem-solving skills.
- Bilingual (English/Spanish) is a plus.
Spherion is a leading staffing agency that helps thousands of people find work happiness. Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company.
We are an equal opportunity employer and welcome people of all abilities. If you require a reasonable accommodation to make your application or interview experience a great one, please contact us.
We offer a comprehensive benefits package, including health, and an incentive and recognition program (all benefits are based on eligibility).
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