Client Services Representative

Job Title

Client Services Representative

Job Description

The Client Services Representative addresses inquiries, questions and concerns in all areas including enrollment, eligibility, claims, benefit interpretation, and referrals/authorizations for medical care. The position is responsible for receiving, responding to, and directing member, broker and provider phone calls and other communications and provides available information upon request and escalates issues as appropriate.

Essential Job Duties

Receives client calls or inquiries, which include potential/current/previous members, brokers and providers, and routes appropriately. Provides timely and accurate information to clients. Processes client requests according to established department policies and procedures. Completes research and investigative activities to address client inquiries. Works closely with other departments to gather information. Provides timely feedback to clients through outbound calling, email, mail or fax. Provides timely feedback to the company regarding service failures, systemic issues or client concerns. Assists in the completion of special projects. Assists in the documentation, evaluation and revision of department policies and procedures. Meets or exceeds service level agreements in call center metrics. Attends and participates in meetings and trainings as required. Regular and predictable attendance. Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice. Works to encourage and promote Company culture throughout the organization. Other duties as may be assigned.

Qualifications

Requires a high school diploma or its equivalent. Ability to learn quickly and be self-motivated. Customer service experience preferred. Confidentiality and time management skills. Bilingual preferred. Knowledge of healthcare billing, claims and insurance a bonus.

Physical Requirements

Prolonged periods of sitting at a desk and working on a computer. Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day responsibilities. Must be able to drive a vehicle and daytime/overnight travel as required.

Benefits

401K (4% Match, Immediate Vesting) Accident insurance Competitive salary Critical Illness Insurance Dental Insurance Employee Assistance Program Flexible Spending Account Health & Wellness Program Health Savings Account Life & AD&D Insurance Long Term Disability Medical Insurance Medical Insurance Paid Time Off Pet Insurance Short Term Disability Vision Insurance

Pre-Employment Screening

Drug Screen and Background Check Required

HealthOne is an Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, disability, sex, age, ethnic or national origin, marital status, sexual orientation, gender identity or presentation, pregnancy, genetics, veteran status or any other status protected by state or federal law.