Customer Service Representative

Customer Service Representative

MagnaCare is seeking a fully remote Customer Service Representative to assist members, physicians, hospitals, and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals. This is a remote position.

Primary Responsibilities

• Greet customers in a courteous, friendly, and professional manner using agreed upon procedures.
• Listen attentively to customer needs and concerns; demonstrate empathy and offer solutions.
• Confirm customer understanding of the solution and provide additional customer education as needed.
• Prepare complete and accurate work and update customer file.
• Communicate effectively with individuals/teams in the program to ensure high quality and timely expedition of customer requests.
• Effectively transfer misdirected customer requests to an appropriate party.
• Contribute ideas on ways to resolve problems to better serve the customer and/or improve productivity.
• Offer solutions to issues that are often non-standard/non-routine and require some clarification.
• Perform other call center functions and support projects as directed by the management.
• Balancing the demands of the caller with program requirements for quality, average handle time, and productivity.
• Use appropriate verbiage and level of detail to formulate and adapt the response to the level of understanding the caller has about the MagnaCare processes and specific plan details.
• Calls will require the CSR to proactively educate the caller and validate understanding before completing the call.

Essential Qualifications

• High School diploma.
• Some college or business school education is a plus.
• Knowledge of basic computer operations.
• Intermediate knowledge of Microsoft Office and email writing.
• Knowledge of CPT codes, ICD-9. Ability to learn quickly.
• Courteous with strong customer service orientation.
• Dependable with proficient attention to detail.
• Good listening and responding skills.
• Must be flexible with the ability to adapt to changes quickly and think conceptually.
• Solid problem-solving skills.
• Excellent attendance, punctuality and work record required.