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Client Support Specialist

2 months ago

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

The Client Support Specialist plays a crucial role in ensuring exceptional service by managing incoming communications in a professional and efficient manner. This position is essential for addressing inquiries from both Members and Providers, delivering accurate and timely information. Additionally, the Specialist is tasked with completing all necessary documentation and reporting associated with the Client Support Department.

Qualifications:

  1. High School Diploma or equivalent.
  2. Strong interpersonal skills to engage effectively with diverse clientele.
  3. Outstanding verbal and written communication abilities.
  4. Basic understanding of healthcare and insurance principles.
  5. Proficient in computer operations and typing.
  6. Effective use of the English language.
  7. Consistently demonstrates a positive demeanor.

Preferred Qualifications:

  1. 1-2 years of post-secondary education with an emphasis on healthcare.
  2. Prior experience in a call center environment.
  3. Familiarity with medical terminology.
  4. Understanding of CPT and ICD-10 coding systems.
  5. Experience with medical and hospital claims processing.

Key Responsibilities:

  1. Handle an average of 40-60 incoming calls each day.
  2. Maintain manageable levels of pending work as necessary.
  3. Ensure timely processing of correspondence, faxes, and emails.
  4. Achieve a monthly monitoring score of 90% accuracy or higher based on established performance metrics.
  5. Exhibit comprehensive knowledge of departmental policies and procedures.
  6. Complete assigned tasks with minimal oversight.
  7. Meet the standards set forth in annual performance evaluations.
  8. Demonstrate continuous improvement in job performance and knowledge.
  9. Document calls in accordance with departmental guidelines.