Call Center Representative

Job Summary:

The Call Center Representative is responsible for addressing inbound & outbound calls and ensuring the highest level of quality customer services to our client's patients.

Supervisory Responsibilities:

This position has no direct supervisory responsibilities.

Duties/Responsibilities:

Take Inbound and make outbound calls to new and existing customers from our PM system

Meet or exceed daily call volume and production goals

Build great rapport with client’s patients to ensure quality customer service

Process transactions assigned as per the defined standard operating procedure.

Meet or exceed the production & quality accuracy target/goals assigned.

Plans, prioritizes, organizes, and completes work to meet established objective.

Ensure the compliance of the company’s policies to cooperate with standards and procedures.

Answer questions and resolve issues for consumers and clients timely and accurately.

Perform other related duties as assigned.

Required Skills/Abilities:

Typing skills and accuracy in keying data required.

Should have strong analysis skills, including the ability to catch data that represents inaccurate/incomplete from the actuals.

Should be good in logical reasoning and connect to the process to catch errors.

Extensive knowledge of medical terminology with the ability to correctly read and assess medical documents.

Basic cognitive skills that include language, math, and reasoning ability.

Solid interpersonal skills with the ability to work with people with diverse backgrounds (both non-technical and highly technical users). Demonstrated ability to build and maintain business relationships internally and externally.

Decision-Making Skills - Capable of arriving at the appropriate decisions after weighing the pros and cons of all the options.

Excellent verbal and written communication skills in addition to be a good listener to give value to the opinion and suggestion of others. This includes ability to communicate with the customers if needed.

Exceptional problem solving and solution driven skills with the ability to review problem, troubleshoot root cause issues and determine path to resolution.

Strong attention to detail to handle the complex claims.

Able to work effectively in a changing environment and be able to contribute innovative ideas.

Excellent time management and organizational skills balancing multiple priorities.

Self-starter, able to independently drive work.

Bilingual English & Spanish a plus

Education and Experience:

1 year of experience in processing healthcare claims

High school diploma or equivalent

Physical Requirements:

Prolonged periods of sitting at a desk and working on a computer.