Customer Service Representative

Job Type


Full-time

Description

Department: Customer Service


Location: Mishawaka

Classification: Non-exempt

Reports to: Manager of Customer Service

Summary:

Representatives will require the ability to multi-task and utilize multiple computer applications to access and enter data in member accounts. Representatives will also be required to conduct themselves in a HIPAA compliant and ethical manner. Duties include, but are not limited to: Incoming and outgoing calls, new account creation, insurance verification, document processing, order set up and management. Representatives will be required to communicate professionally with members, caregivers, guardians, medical professionals, and co-workers.


Essential Functions:

1. Handle a variety of incoming calls regarding new and/or existing members/caregivers needs
2. Ability to multitask using multiple computer applications/programs
3. Review/Update all demographic and personal health information in the member's account, including but not limited to the following: address - both mailing and shipping if different, phone number(s), e-mail address(es), physician information, caregiver(s), etc.
4. Access and enter data in existing patient accounts following HIPAA guidelines.
5. Insurance verification following established verification processes.
6. Speaks with members, caregivers, doctors and other outside providers to regarding member account and product needs.
7. Document all interactions in patient medical records for proper record keeping (account notes).
8. Documentation creation and follow up to ensure necessary documentation on file to ship supplies per Insurance guidelines (Advanced beneficiary Notification, Certificate of Medical necessity, Prescriptions, Letter of Medical Necessity, etc).
9. Fax and review incoming documentation as needed
10. Communication with patient or caregiver to keep up to date on account statuses
11. Liaise with Team Support or Team Lead as needed for all important matters that require supervisor approval or intervention.
12. Utilize the Customer Service Wiki daily for processes, procedure, insurance guidelines, product and company information.
13. Build proficiency and strong knowledge base on all product lines serviced.
14. Makes suggestions for process improvements and assists with projects as able.
15. Submit reports and productivity tracking to leaders as requested.
16. Track attendance and submit all applicable requests using the attendance system.
17. Follow established building entry, compliance and system security policies.
18. Adhere to all Nondiscrimination and Accessibility guidelines.
19. Knowledge of all aspects of the company including cash sales, department structure, accessibility tools, websites, etc.

Key Competencies:

1. Accountability
2. Action Oriented
3. Communicates Effectively
4. Customer Focus
5. Nimble Learning
6. Being Resilient
7. Resourcefulness
8. Self-Development
9. Instills Trust

Requirements

Supervisory Responsibilities:

The Customer Service Representative has no supervisory responsibilities.


Work Environment:

This job is performed in an office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands:

While performing the duties of this job, the employee is regularly required to speak, hear and see. The employee is frequently required to stand, walk, use hands to finger, handle or feel and reach with hands and arms.


Position Type:

This is an hourly position, business hours, M-F. Occasional OT, early mornings, evening and weekend work may be required as workload demands.


Travel: This position does not require travel.

Required Education and Experience:

1. High school diploma or GED

Other Duties:

All other duties as assigned by management. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are request of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.