Customer Service Representative

About The Role MagnaCare is seeking Customer Service Representatives to assist members, physicians, hospitals, and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals. Communicate effectively with individuals/teams in the program to ensure high quality and timely expedition of customer requests.

About The RoleMagnaCare is seeking Customer Service Representatives to assist members, physicians, hospitals, and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals.Primary Responsibilities

• Greet customers in a courteous, friendly, and professional manner using agreed upon procedures.
• Listen attentively to customer needs and concerns; demonstrate empathy and offer solutions.
• Confirm customer understanding of the solution and provide additional customer education as needed.
• Prepare complete and accurate work and update customer file.
• Communicate effectively with individuals/teams in the program to ensure high quality and timely expedition of customer requests.
• Effectively transfer misdirected customer requests to an appropriate party.
• Contribute ideas on ways to resolve problems to better serve the customer and/or improve productivity.
• Offer solutions to issues that are often non-standard/non-routine and require some clarification.
• Perform other call center functions and support projects as directed by the management.
• Balancing the demands of the caller with program requirements for quality, average handle time, and productivity.
• Use appropriate verbiage and level of detail to formulate and adapt the response to the level of understanding the caller has about the MagnaCare processes and specific plan details.
• Calls will require the CSR to proactively educate the caller and validate understanding before completing the call.

Essential Qualifications

• High School diploma.
• Some college or business school education is a plus.
• Knowledge of basic computer operations.
• Intermediate knowledge of Microsoft Office and email writing.
• Knowledge of CPT codes, ICD-9. Ability to learn quickly.
• Courteous with strong customer service orientation.
• Dependable with proficient attention to detail.
• Good listening and responding skills.
• Must be flexible with the ability to adapt to changes quickly and think conceptually.
• Solid problem-solving skills. 
• Excellent attendance, punctuality and work record required.

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