Medical Customer Support Representative

2 weeks ago


Chattanooga, Tennessee, United States Global Channel Management Full time
Position Overview:

The Medical Customer Support Representative plays a crucial role in providing assistance and guidance to members regarding healthcare benefits and services. This position requires a minimum of 2 years of experience in a customer service capacity.

Key Requirements:

  • Potential COVID-19 vaccination requirement.
  • Familiarity with medical terminology.
  • Experience in a customer service support role is essential.
  • Ability to work autonomously with minimal oversight or collaboratively within a team, sharing responsibilities and accountability.
  • Strong interpersonal and organizational abilities.
  • Independent decision-making and problem-solving capabilities.
  • Must demonstrate creativity and self-motivation in task management.
  • Proficient in managing multiple priorities effectively.
  • Excellent time management skills.
  • Outstanding verbal and written communication skills.
  • Robust interpersonal and organizational skills.

Responsibilities:

  • Assist the clinical team by serving as a proactive resource for members, focusing on disease prevention and benefit education.
  • Conduct educational outreach calls to inform members about available benefits, services, and programs; perform health needs assessments and refer members to appropriate health management programs.
  • Engage with members who have identified care gaps, motivating them to comply with health recommendations and assisting in locating providers and scheduling appointments.
  • Manage system work queues by screening members for eligibility, reviewing prior case activities, recent claims, customer service inquiries, and authorization history; assign members to the clinical team for outreach and intervention.
  • Facilitate the research and analysis of inquiries or complaints related to processes, member incentives, and other program-related issues.
  • Be available for overtime work as required.


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