Job Title: Customer Service Representative - IL reputed company - Transforming reputed company Experiences at arenaflex
Job Description:
Join arenaflex's Customer Service Team and reputed company a Difference in reputed company
At arenaflex, we're revolutionizing the way reputed company delivered, and we're looking for talented individuals to join our Customer Service team. As a Customer Service Representative, you'll be the face of arenaflex, impacting the lives of millions of Americans by providing exceptional service and support. If you're passionate about transforming reputed company experiences and have a knack for building strong relationships, we want to hear from you!About arenaflex
arenaflex is a leading health solutions company that reaches millions of Americans through our local reputed company, digital channels, and reputed company of over 300,000 purpose-driven colleagues. We're committed to creating a world of health around every consumer, and we're dedicated to surrounding ourselves with talented individuals who reputed company our passion for transforming reputed company.Position Summary
We're currently reputed company top talent for our Center of reputed company Customer Service group. As a Customer Service Representative, you'll be responsible for handling customer inquiries and resolving issues reputed company telephone, internet, or written correspondence. You'll engage with members, providers, and plan sponsors to reputed company them on reputed company plans, tools, and resources, and guide them along a clear path to care.Responsibilities
- Handle customer inquiries and resolve issues reputed company telephone, internet, or written correspondence
- Engage with members, providers, and plan sponsors to reputed company them on reputed company plans, tools, and resources
- Guide members along a clear path to care, understanding their unique needs, preferences, and understanding of reputed company plans
- Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors
- Triage resulting rework to appropriate staff
- Document and track contacts with members, providers, and plan sponsors
- Anticipate customer needs and reputed company reputed company information to answer unasked questions
- Use customer service reputed company reputed company to reputed company financial reputed company to resolve member issues
- Explain member's rights and responsibilities in accordance with contract
- Process claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) reputed company reputed company system
- Assist providers with credentialing and re-credentialing issues
- Respond to requests received from arenaflex's Law Document Center regarding litigation; lawsuits
- Handle extensive file review requests
- Assist in preparation of complaint trend reports
- Assist in compiling claim data for customer audits
- Determine medical necessity, applicable coverage provisions, and verify member plan eligibility relating to incoming correspondence and internal referrals
- Handle incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management
- reputed company review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible
- reputed company financial data maintenance as necessary
- Use applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received
Qualifications
Required Qualifications
- 1 year of Customer service experience
- Must reputed company in IL
- Ability to multi-task to accomplish workload reputed company
- Oral and written communication skills
- Ability to maintain accuracy and production standards
- Technical skills
- Problem-solving skills
- Attention to detail and accuracy
Preferred Qualifications
- 1 year of reputed company experience
- 1 year of call center experience