As a Customer Service Representative you will: directly respond to questions, handle issues and provide guidance on transactions, inquiries or complaints from both internal and external customers. External customers would include members and providers. Receive, document and resolve customer inquiries by using established best practices. Build lasting relationships with client members. Educate members and providers about products and services over the telephone.
Role and Responsibilities:
Respond to complex customer calls.
Resolve customer service inquiries which could include: Benefit and Eligibility information; Billing and Payment issues; Customer material requests; Physician assignments; Authorization for treatment; and Explanation of Benefits (EOB)
Must be able to handle volatile situations and act urgently when necessary.
Must be willing and able to work flexible hours, including some weekends during specific times of the year and over time when needed.
Makes outbound calls to any source needed to resolve open issues including but not limited to members, providers, pharmacies, hospitals etc.
Issue form letters & forms, when appropriate.
Investigates and respond to general correspondence, which may result in a variety of additional actions.
Must have strong investigative, problem solving skills.
Must be very detailed oriented and organized.
Ability to read and comprehend instructions in a very changing environment.
Ability to interact with other department’s i.e. Enrollment, medical management in resolving issues.
Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications.
Experience, Qualifications and Education:
High school diploma or general education degree (GED).
Minimum of 2 years HealthCare/insurance experience.
Proficiency in all Microsoft Office Programs, including Word, PowerPoint, Excel, and Access.
Ability to type 30-45 wpm.
Prior Customer Service & Claims adjudication experience in the healthcare field along with working knowledge.
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With headquarters in St. Louis, Missouri, we have more than 35 years of experience solving the ever-challenging dilemma of connecting business and IT professionals. We know making that precise connection can be challenging—for our clients as well as for our consultants looking for new positions. This is where Concero Technology Group comes in. Our team has had more than 1000 placements in St. Louis, Missouri in the past 16 years. We pride ourselves on paying attention to the details and our follow through. Join the Concero team today, and let us help connect you and your goals!
Our Core Focus We connect business and IT professionals – because that is what we do best! We know the people. We know the business. And we know how to bring it all together and make everyone successful.
Our Core Philosophy Help our clients and consultants succeed. We listen, understand, identify and deliver successful results. Our Core Values We believe in integrity and hard work and are passionate about placement.