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Call Center Representative

Alluvion Staffing Forest Park Full-Time
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Alluvion, is hiring for Call Center Representatives for our client in Cincinnati, OH.

Position Summary:

The Call Center Representative provides expert service to providers, members and clients who have claims, eligibility and benefit related questions by promptly responding to their concerns in a timely manner. In addition, this position resolves payment/adjudication questions at the time the call is received; explaining calculation methodology, contract terms procedures, etc. for the designated call center.

Essential Functions:
  • Help providers and members navigate the complex healthcare ecosystem
  • Field member and provider inquiries by phone and email
  • Customer service focus with a keen understanding of the importance of average speed of answer, average handle times, abandonment rates, and first call resolution
  • Answer customer service lines promptly and professionally and maintain at least a 95% response time.
  • Collaborate with teammates to investigate and resolve complex calls
  • Provide feedback to improve the Company
  • Clearly communicates claims status, payment methodology, contract terms, procedures, etc. to providers, members and clients.
  • Informs and assists callers with the claim's appeals process, where appropriate.
  • Demonstrates excellent customer service by determine the reason for the call, acknowledging the callers concerns and resolve concerns and/or explain action to be taken within the expected time line for resolution.
  • Performs research on complex claim inquires and expertly re-examines claims in order to drive first call resolution
  • Presents a pleasant voice to all callers, regardless of the stressful nature of the situation.
  • All other duties as assigned.

Minimum Qualifications:
  • Call Center experience necessary; healthcare call center experience with claims experince preferred
  • Demonstrated knowledge of health claims, coding and processing guidelines.
  • Maintain a knowledge of plan designs, PPO, indemnity plans, and all other contracts and services provided by company.
  • Medical terminology and insurance related experience a plus.
  • Strong interpersonal skills to interact with customers, management and peers.
  • Very organized and detail-oriented.
  • High level of self-motivation, productivity and attention to detail; be well-organized; have excellent verbal and written communication skills
  • Excellent analytical, problem-solving, multi-tasking, verbal and written communication skills
  • Flexibility to work evening hours based upon business need
  • Excellent attendance required
.
 

Skills required

Customer Service
Assist Individual
Telephone Skills
Update Customer Information
Take Customer Order
Utilize Questioning Skill

Location

Salary Estimator

Based on Job Title, Location and Skills
$37K
Below Avg. Average Above Avg.

Career Path

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Call Center Representative
Estimated Salary: $64K
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Job ID: 19-00924

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