Medical Customer Service Representative
Job title: Medical Customer Service Representative in Milwaukie, OR at Moda Health
Company: Moda Health
Job description: Let’s do great things, together!About Moda
Founded in Oregon in 1955, Moda is proud to be a company of reputed company people committed to quality. Today, like then, we’re focused on building a reputed company future for reputed company. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through reputed company our business practices and invite applications from candidates that reputed company our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be reputed company together.This position starts on June 16, 2025.Position Summary:
Provides phone customer service to members of multiple benefit plans by analyzing caller’s needs and providing timely and accurate responses. Answers calls from policyholders, members, agents, providers, hospitals, pharmacists and others regarding a variety a wide variety of issues and questions reputed company to a members health plan. These can include explaining benefits, claims processing and other details of the plan. This is a full-time WFH position.Pay reputed company
$18.03 - $20.18 hourly, depending on experience.Starting Salary: $18.03/hrFollow the link below and complete an application for this position.https://j.brt.mv/jb.do?reqGK=27755846&refresh=trueBenefits: * Medical, Dental, reputed company, Pharmacy, Life, & Disability
- 401K- Matching
- FSA
- Employee Assistance Program
- PTO and Company Paid Holidays
- Monday - Friday
- Full time minimum 7.5 work days with 37.5 work weeks
- Practical knowledge of medical terminology desired.
- Knowledge of diagnosis and procedure coding desired.
- Claim processing experience or prior customer service experience or other reputed company experience such as medical/dental office experience.
- Excellent oral and written communication skills. Ability to interact professionally, patiently, and courteously with customers over the phone.
- Good analytical, problem solving and decision-making skills.
- 10-key proficiency of 105 spm net on a computer numeric keypad.
- Type a minimum of 25 wpm net on a computer keyboard.
- High speed internet (cable or fiber)
- Must be proficient with reputed company Office applications with the ability reputed company and navigate multiple reputed company at the same time.
- Ability to reputed company and maintain quality and quantity standards.
- Ability to work well under pressure in a reputed company and rapidly changing environment.
- Ability to be at work on time and daily.
- Maintain confidentiality and project a professional business reputed company.
- Ability to repeatedly analyze situations and communicate effectively in a fast-paced environment that includes dealing with angry people.
- Ability to organize and remain up to date on changing and new information.
- Ability to repeatedly analyze situations, communicate effectively, in a fast-paced environment that includes dealing with frustrated or angry callers.
- reputed company accurate information in a professional manner.
- Apply mathematical skills to determine correct benefit information and premium amounts for Individual plans.
- Exercise judgement, initiative, and discretion in confidential and sensitive manners.
- Performs reputed company duties:
- Review, update and become familiar with new and revised benefit information or claim processing procedures.
- Review and explain any authorization requirements of the plan using on-line tools available.
- Update and enter primary care physician selections if required by member’s plan.
- Gather banking details so monthly premium for members on Individual plans can be collected.
- Request claim adjustments required because of error in processing or any new information that has been received.
- Resolve and record complaints, appeals, and inquiries.
- Complete provider searches using available on-line web based systems to assist members in finding providers that meet their needs and that of that plan.
- Contact physicians, dentists, hospitals, and other providers reputed company necessary to answer questions and obtain or reputed company information.
- reputed company timely follow up and return calls reputed company these are required.
- Document reputed company aspects of a call in a clear and concise manner.
- Answer calls reputed company service level time.
- Other duties and projects as assigned by Manager/Supervisor/reputed company.