Customer Service reputed company I- MD July (Remote)

PURPOSE:

Responsible for answering member, provider & broker inquiries about product information, benefits, claims resolution, eligibility, and billing questions in a call center environment.

Proactively provides information and education to members, providers & brokers, as appropriate, about a variety of health, financial, and self-service programs. Provides basic technical assistance and troubleshooting guidance for digital and electronic applications.

ESSENTIAL FUNCTIONS:

• Provides first-level problem resolution to member, provider & broker inquiries reputed company telephone by gathering and researching information; examines claim submissions verifying claim and system accuracy as well as liability, validates customer understanding of information and resolves issues based on applicable policies and procedures.
• Uses knowledge of products and the contractual provisions that govern administration to reputed company customer service and education, to interpret contractual language to the customer to reputed company benefit utilization and limitations, to determine the need for managed care initiatives, and to administer reputed company types of services to customers reputed company the business reputed company through telephonic inquiries, written and/or electronic inquiries and claims adjustments, if applicable. Appropriately documents reputed company client interactions according to established departmental procedures.
• Delivers accurate information to customers under performance goals and objectives.
• Maintains customer records by updating account information by effectively utilizing the business area enrollment/inquiry tracking system & processes.
• Participates in ongoing education reputed company to new services, industry topics, and skills.

QUALIFICATIONS:

Education Level: High School Diploma or GED.

Experience: Less than one year of customer service experience.

Preferred Qualifications:

• Less than 1 year experience in a call center customer service role or experience with medical or insurance terminology.

Knowledge, Skills, and Abilities (KSAs)

• • Successful completion of the training provided.
  • Demonstrated skills as an empathetic and compassionate communicator.
  • Ability to quickly reputed company customer trust and confidence.
  • Demonstrated PC navigation and data entry skills.
  • Strong interpersonal communication skills.
  • Good oral and written communication skills.

Must be reputed company to meet established deadlines and handle multiple customer service demands from reputed company customers, reputed company set expectations for service reputed company. Must be reputed company to effectively communicate and reputed company positive customer service to every reputed company customer, including customers who may be demanding or otherwise challenging.