Customer Service Senior Representative

Customer Service Representative

Candidates must have a quiet and private working environment. Expected to take inbound and outbound calls during their entire shift. Candidates must have a hard wired internet connection, WiFi will not suffice. Delivers specific delegated customer service tasks assigned by a supervisor. Receives requests by mail, telephone, or in person regarding insurance claims/policies. Responds to inquiries from policy holders, providers and/or others for information and assistance.

Performs research to respond to inquiries and interprets policy provisions to determine most effective response. Mails or routes claim forms and supporting documentation to various units for final processing. Position typically requires excellent interpersonal skills, ability to understand and interpret policy provisions. Independently responds to inquiries, grievances or complaints of moderate to substantial complexity. Completes day-to-day tasks without immediate supervision, but has ready access to advice from more experienced team members.

Tasks involve a degree of forward planning and anticipation of needs/issues. Resolves non-routine issues escalated from more junior team members. This is a Flex role, workers must be able to report onsite. Previous experience in the healthcare industry 1+ years with third-party benefits verification experience preferred. Basic knowledge of Outlook, Excel, Word, MS Office, SharePoint required. Excellent verbal and written communication skills.

Ability to interpret and appropriately follow policies, procedures, manuals, and written instructions as given. Demonstrated ability to handle challenging situations in a professional manner. Willingness to work varying tasks. Knowledge of healthcare pharmaceutical and services a plus. 3 Non-Negotiable

Skills:

- Attention to detail - Knowledge of Third Party Insurance Carrier Processes - MUST have experience taking inbound and outbound calls (30 calls per day)