Customer Service Representative

10 hours ago


Seattle, Washington, United States The Jacobson Group Full time

Job Title: Customer Service Representative

Job Summary: We are seeking a skilled Customer Service Representative to join our team at The Jacobson Group. As a Customer Service Representative, you will provide exceptional service to our clients and customers, ensuring their needs are met and exceeded in a timely and professional manner.

  • Responsibilities:
  • Provide information, education, and assistance to members, providers, and other stakeholders regarding benefits, claims, and eligibility.
  • Communicate effectively with a variety of subscribers, providers, healthcare providers, and other stakeholders through various media channels.
  • Assess customer inquiries and requirements, identifying errors and determining corrective steps to resolve issues.
  • Apply benefits according to contract, determining benefit payments, maximum allowable fees, co-pays, and deductibles.
  • Make appropriate corrections to denied, process-in-error, or re-classified claims.
  • Explain benefits, rules of eligibility, and claims payment procedures to ensure understanding.
  • Maintain confidentiality and sensitivity in all aspects of internal and external contacts.
  • Manage high volumes of calls, prioritize follow-through, and document inquiries and actions on tracking systems.

Requirements:

  • A government programs-related job with thorough knowledge of State and Federal regulations.
  • Keyboarding skills of 30 wpm with 95% accuracy.
  • Proficient PC skills and prior experience in a PC environment.
  • Demonstrated knowledge of medical terminology and coding preferred.
  • Ability to apply mathematical concepts and calculations.
  • Ability to communicate effectively orally and in writing.
  • Demonstrated ability of strong customer-service skills.
  • Ability to make decisions and exercise good judgment in a complex environment.
  • Ability to work under stress and pressure, responding to inquiries with tact, diplomacy, and patience.


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