SKYGEN USA

SKYGEN USA is on a mission to transform the delivery of healthcare benefits, specifically for the vision and dental industries. The company develops innovative

Customer Care Representative II

Location

United States

Posted

5 days ago

Salary

$16 - $24 / hour

Seniority

Entry Level

No structured requirement data.

Job Description

Customer Care Representative II

SKYGEN USA

Title: Customer Care Rep II - Fully Remote! Location: United States Job Description: Important things YOU should know: - Fully remote opportunity - Training schedule 8:00am - 4:30pm Monday – Friday CST for the 1st 12 weeks - Work schedule (after training): 10:30am - 7:00pm CST Mon - Fri - Hours of operation: 6:00am - 10:00pm CST Monday - Friday so shift could flex based on business need - $2.00/hour differential on Mon/Tues - Occasional evenings, weekends and holidays possible during Annual Medicare Open Enrollment: 10/1 - 3/31 - Exceptional professional growth in a fun rewarding environment - Experience with Dental or Health insurance a preferred plus What will YOU be doing for us? Our Customer Service Representatives must have strong problem-solving skills, coupled with the natural ability to provide empathy for the customer – always taking the time to patiently listen and understand their questions to help find a viable solution, while providing them with a memorable customer experience. What will YOU be working on every day? - Servicing our Dental and Vision inbound callers with information regarding their eligibility, benefit coverage, authorizations, claims, and assisting them with locating a provider in their area, - Utilize knowledge of claim adjustments and resubmission processes to determine appropriate resolution to provider requests. - Provide feedback to Provider Relations staff on high-level claim issues including but not limited to issues with reimbursement schedules or conflicting information to ensure providers receive a prompt resolution. - Support enrollment activities including but not limited to assigning primary care providers, and updating third party insurance information. - Act as liaison between our organization and the client’s Member Services staff to resolve issues such as eligibility and filing appeals and grievances. - Provide updates to providers with questions regarding the status of their credentialing application. - Recognize provider questions that could be handled through the use of the provider web portal and provide education to these callers on the benefits of utilizing the technology available. - Ensure all calls are answered according to company and client guidelines. - Accurately document call information and resolution in our internal systems. - Apply effective diffusion techniques when necessary to ensure our customers feel heard, valued and supported. - Properly identify issues that need to be escalated appropriately to the leadership team. Additional Responsibilities: - Provide recommendations on system enhancements and process improvements to management. - Keep our Provider Relations team updated with provider manual discrepancies, change in locations or any other provider related issues. - Participate in departmental projects when applicable. What qualifications do YOU need to have to be GOOD candidate? Required Level of Education, Licenses, and/or Certificates - High school diploma or equivalent. - Required Level of Experience - 1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail. Required Knowledge, Skills, and Abilities - Basic knowledge of Microsoft Office products including but not limited to Word, Excel, and Outlook. - Ability to work occasional overtime as needed. - Excellent listening and communication skills. - Superior customer service skills including the natural ability to provide empathy. - Strong data entry/typing skills. - Strong navigation skills and the ability to multi-task. - Excellent attention to detail. - Critical thinking skills to quickly analyze and clearly understand a specific request or customer need and then leverage knowledge and resources to provide the appropriate solutions. What qualifications do YOU need to be a GREAT candidate? Preferred Level of Experience - 1+ years of job related customer service experience within the dental, vision or medical industry. - Previous experience working in a virtual environment. - Understanding of dental, vision and/or medical insurance terminology. Job Info - Job Identification3287 - Job CategoryNon-Exempt - Job ScheduleFull time - Locations United States(Remote) - Pay Range$16.42 - $24.63

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