|Title:||Customer Service Representative|
Summary: The Customer Service Representative is responsible for interacting with customers over the phone to provide insurance benefits related information. This person will respond to inquiries to both providers and members about their benefits or payment history and to handle and resolve complaints.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Answer calls and/or correspondence (emails) from members, client, & providers
- Review Health Benefit plans to accurately quote to members / providers and use that information to answer questions.
- Problem solving ability & empathy
- Enter pre-claim information and attach scanned documents
- Ability to handle upset provider or members
- Direct any questions or problems to claims examiners or adjusters that cannot be resolved at the customer service level.
- Proficient in Microsoft software
- Open, sort, scan mail
- Education – High School Diploma or GED
- Experience – Must have at least 2 years benefits experience in a TPA environment.
- Ability to read and understand various benefit forms, documentation, files and information in the department
- Understanding of medical terminology.
- Excellent interpersonal skills
- Compensation based on experience
- Benefits – Medical, Dental, Vision, 401(k), Short Term Disability, Long Term Disability, Tuition Assistance, PTO
- Great work/life balance – Flex time after 90 days
For more information, please visit our website at www.groupmgmt.com