Healthcare Customer Service Representative

Healthcare Customer Service Representative

Requirements

• High School diploma or GED required.
• One (1) to three (3) years of customer service experience required.

Responsibilities

• Answering incoming calls from providers and members
• Provides eligibility, claims and authorization status.
• Retrieves voice mails and responds.
• Collaborates with internal and external partners to resolve issues from providers or members as they relate to claims payment, authorization and eligibility inquiries.
• Creates, tracks and completes Customer Service Incidents to internal departments to resolve caller issues.
• Participate in the discovery and resolution of root cause for recurring issues.
• Ensure that all customer needs and problems are properly communicated and managed in a way that maintains great customer relationships.
• Use customer service best practices to ensure a positive customer experience.
• Meets daily, weekly, monthly metrics as written.
• Other duties and responsibilities as assigned.

Preferred Qualifications

• One (1) to three (3) years in the Health Insurance Industry preferred.
• Claims payor experience preferred, but not required.