Customer Service Representative

Customer Service Representative

The Customer Service Representative is responsible for answering phone calls in a prompt and courteous manner to achieve contractual obligations. Responsible for answering member's and provider's questions with a quick and accurate response. They are also responsible for timely completion of all correspondence and reporting functions associated with the Customer Service Department.

Required:

• High school graduate or equivalent.
• Strong ability to relate to all customers.
• Excellent communication skills.
• Some knowledge of health care and insurance.
• Computer and keyboard skills.
• Proper usage of the English language.
• Consistently displays a positive attitude.

Desired:

• 1-2 year post high school education with focus on healthcare.
• Previous call center experience.
• Knowledge of medical terminology.
• Knowledge of CPT and ICD-10 coding.
• Familiar with medical and hospital claims.

Responsibilities:

• Takes an average of 40-60 incoming calls daily.
• Keeps pending work at tolerable range (when applicable).
• Manages to work correspondence, faxes and e-mails in a timely manner.
• Maintains monthly monitoring score of 90% accuracy or above on the 17 points of excellence.
• Demonstrates a complete understanding of departmental policies and procedures.
• Able to perform assigned tasks with minimal supervision.
• Meets requirements on annual performance evaluation.
• Increasing improvement in performance and job knowledge.
• Documents calls according to departmental guidelines.

Equal opportunity employer.