Customer Service​/Call Center Representative - Adjudication

We’re thrilled that you are interested in joining us here at the Amynta Group!

Provides exceptional customer service to internal and/or external customers. Responsibilities include but are not limited to: processing claims, providing standard information, completing forms, determining status of claims based on plan guidelines and meeting or exceeding department metrics for call handling, productivity and quality.

Assists consumers by providing highest level of customer service; remains professional and polite at all times.

Responds to standard questions and concerns from customers; follows-up with common questions to document nature and status of claim; communicates in a clear and educated manner.

Processes routine or standard claims and a variety of forms based on documentation and categorization of claims; informs customer of results and closes out claim as appropriate; requests and reviews photos/receipts to complete processing if necessary.

Receives incoming calls from consumers to resolve claims; utilizes judgement and problem-solving skills to deliver accurate information in a timely manner; makes outbound phone calls to consumers; documents information as required.

Aids internal and external customers during claim and general call center process; forwards call and relevant information to other team members, departments or management as needed.

Serves as a mentor to new hires or other staff, which may include providing direction and training.

Performs other duties as assigned.

• 1-year minimum customer service experience in a call center environment is preferred;
• Office or customer service experience is preferred;
• High school graduate or equivalent education is required;
• Post-secondary education is preferred.

• Mastery of the English language (both written and verbal);
• Professional telephone etiquette;
• Ability to read and interpret information;
• Proficient computer and data entry skills; comprehensive knowledge of computer operations, including software and web-based programs;
  Applix;
  Microsoft Office applications (Outlook, Word, Excel, PowerPoint, etc.);
• Ability to solve problems; diffuse escalated customer situations; excellent decision-making skills;
• Self‑motivated with strong work ethic, time management and interpersonal skills; ability to work well with others;
• Ability to operate dual screens and multitask; detail‑oriented; follows instructions;
• Knowledge and understanding of department metrics for call handling and quality;
• Willingness to learn; flexibility to adapt to changes;
• Maintain professional appearance and provide positive company image.

Professional office and call center environment.

Positions in this class typically require: typing, talking, writing, hearing, seeing and repetitive motions.

Sedentary Work:
Exerting up to 10 pounds of force occasionally and or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.