Health Insurance Customer Service Representative

Overview

The Customer Service Representative works under close supervision to provide customer service to our members for our health, dental, and vision plans by performing the following duties.

• Receives telephone inquiries regarding various aspects of the group health, dental, and vision program such as claims, eligibility, and coverage questions. Educate members on plan benefits, coverage limitations, and coinsurance/deductibles/out-of-pocket maximums using plain, clear language. Protect member privacy and comply with HIPAA and company policies to verify caller and ensure proper documentation is on file before releasing protected health information
• Maintain accurate record keeping for member providing summary of call, listing any actionable items, creating follow-up tasks when necessary, and indicating resolution of call.
• Navigate multiple systems while assisting members to search for information in knowledge base system, claims payor systems, and benefits administration system.
• Conducts research and resolves issues for customer inquiries in a timely manner.
• Responsible for prepping documents for scanning purposes and handling outgoing mail. Provides additional administrative support for the department. Other testing, projects and duties as assigned related to the job.

• Required
  
  Education:
  
  High school diploma or general education degree (GED)
• Required
  
  Work Experience:
  
  One to two years of related experience and/or training, or equivalent combination of education and experience.
• Technology
  
  Skills:
  
  Ability to operate PC, Copy machine, scanner, fax machine and telephone. Proficient with Microsoft Office
• Required skills or traits for the position: Strong customer service skills including active listening, empathy, attention to detail, and problem solving. Ability to organize and prioritize tasks and work assignments; ability to complete multiple tasks simultaneously with accuracy and quality. Excellent written and oral communication skills.
• Specialized
  
  Certifications:
  
  Must be willing to obtain Iowa Accident Health and Life insurance license within the first year of employment.