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Customer Service Representative II
2 months ago
Job Summary
At Memorial Hermann Health System, we are dedicated to delivering high-quality, efficient care while creating exceptional experiences for every member of our community. As a Customer Service Representative II, you will play a vital role in responding to inquiries from subscribers, providers, and clients in a timely and courteous manner.
Key Responsibilities
- Efficiently and courteously respond to telephone inquiries from subscribers regarding benefit verification, claims issues, and eligibility.
- Interpret plan coverage for subscribers and providers to determine correct level of benefit coverage.
- Provide claim filing instructions when needed to subscribers and providers.
- Provide telephone assistance to subscribers and providers, and verify eligibility as required.
- Promptly return phone calls resulting from inquiries that require additional research.
- Efficiently enter data simultaneously while listening attentively.
- Provide a high degree of confidentiality/discretion and independent judgment.
- Keep workstations stocked and organized at all times.
- Perform daily clerical duties, including sending faxes, making copies, and assisting in other areas.
- Efficiently make requested changes (temporary address changes, ID card requests).
- Ensure safe care to patients, staff, and visitors, adhere to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity, and quality of service.
- Promote individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.
- Demonstrate commitment to caring for every member of our community by creating compassionate and personalized experiences. Model Memorial Hermann's service standards by providing safe, caring, personalized, and efficient experiences to patients and colleagues.
Requirements
- Three (3) years Customer Service or Claims processing experience in a TPA or HMO environment.
- Bilingual preferred.
