Careers

Primary Responsibilties

• Provide an exceptional customer service experience when responding to and resolving customer service inquiries and issues by identifying the topic and type of assistance the caller needs. This may include researching complex issues (such as Medical, Dental, Vision, Pharmacy, etc.) across multiple databases and working with support resources to resolve customer issues on behalf of the member in real time or through comprehensive and timely follow-up with the member.
• Intervene with care providers (physicians and hospitals) on behalf of the member to assist when needed.
• Establishing and maintaining professional rapport with clients and providers (physicians and hospitals).
• Provide accurate benefit information to providers (physicians and hospitals).
• Obtaining claim information by telephone, as well as by hard copy, and entering into the computer system.
• Maintaining and assuring accuracy of documentation.
• Prioritization of individual work flow associated with the case assignments.
• Any other duties as requested by the Manager.

Required Qualifications

• High school diploma or equivalent.
• 1 year customer service experience in an office or professional setting required.
• Demonstrated ability in using computer and Microsoft Office, which includes mid-level knowledge of Excel and learning new computer programs.
• Accurate data entry skills.
• Excellent oral and written communication skills.
• Demonstrate ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the clients and providers (physicians and hospitals).
• Flexibility to customize approach to meet all types of client and provider (physicians and hospitals) communication styles and personalities.
• Proficient conflict management skills to include the ability to resolve issues in a stressful situation and demonstrate personal resilience.
• Ability to multi-task in a fast paced environment, as well as, the ability to understand multiple products and multiple levels of benefits within each product.
• Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule and work over-time as needed.

Preferred Qualifications

• Minimum of 2 years of experience working in the medical field.
• Superior skills in health plan benefit interpretation.
• Familiarity with medical terminology.

Schedule

• 8 hour shift
• Monday to Friday

Benefits

• Dental insurance
• Paid time off
• Vision insurance