Customer Service Representative - Work From Home

Job Title

Pay Range $13hr - $18hr

Requirement/Must Have

• High School diploma or GED required. College courses preferred.
• 1+ years of customer service and claims experience or an equivalent combination of education and experience is required. Inbound call center experience preferred.

Responsibilities

• Acts as primary liaison with callers; follows client specifications in assisting with questions and solving problems related to the claims process and servicing processes.
• Educates and informs the customer via multiple communication channels about documentation required to process a claim, required time frames, payment information, and claim status.
• Educates members and providers on client requirements and benefit plans documenting all required details of the call in a concise professional manner.
• Enters verbal and written application information that meets both the internal and external customers requirements accurately into the claims management system.
• Assigns new claims to the appropriate claims handler. Directs customer calls to the appropriate contact at multiple locations or escalates to Service Center Specialist/management as needed.
• Attendance during scheduled work hours is required. Performs other duties as assigned. Supports the organization's quality program(s).

Skills

• Knowledge of medical terminology.
• Understanding of claims management.
• Excellent oral and written communication.
• PC literate, including Microsoft Office products and must be comfortable on camera when requested.
• Analytical and interpretive skills.
• Strong organizational skills.
• Good interpersonal skills.
• Ability to multitask in a fast-paced environment.
• Ability to support multiple clients across communication channels and utilize multiple systems simultaneously.
• Ability to work in a team environment and/or independently.
• Ability to meet or exceed Performance Competencies.