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Customer Service Representative

Customer SupportCustomer SupportOtherRemoteSeniorTeam 1,001-5,000H1B No SponsorCompany SiteLinkedIn

Location

Alabama + 3 moreAll locations: Alabama | Illinois | Iowa | Nebraska

Posted

113 days ago

Salary

$14 - $16 / hour

Seniority

Senior

High SchoolEnglish

Job Description

Customer Service Representative

One80 Intermediaries

• Answering incoming telephone calls • Providing eligibility and claim information to medical providers and members • Reviewing and interpreting plan certificates to determine covered benefits and limitations/exclusions • Investigating claim payment issues • Researching PPO websites/database as required to determine if claims are received and processed by the PPO network • Documenting telephone call reason and details in claim system • Monitoring and answering voice mail • Reviewing inventory tool for status requests from providers/members and responding professionally • Initiating check inquiries (check tracers) from providers and members to determine if claim payment was received • Understanding HIPAA Regulations and Requirements as it relates to Personal Health information • Educating medical providers and members on new technology available to access plan information • Using probing skills to identify customer questions/concerns regarding plan coverage/benefits and providing single call resolution • Maintaining minimum call standards in accordance with company policy, industry standard & other applicable TPA or SLA agreements • Completing special projects as required or requested by management

Job Requirements

  • Effective time management skills
  • Ability to function independently within established guidelines
  • Excellent interpersonal, oral and written communication skills
  • Intermediate skill level in Microsoft Office programs
  • Problem/issue resolution capability
  • Ability to handle multiple tasks, strong organizational/follow up skills
  • Ability to work effectively in a fast paced team based environment
  • Computer experience with related claims and business software

Benefits

  • Health insurance
  • Flexible work arrangements
  • Paid time off

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