Portal Services Representative I

Job Title

Increase member, provider and client use of our web based solutions for claims submission, payments, and authorizations.

Job Description

Important things YOU should know:

• Training & Production Schedule: Monday - Friday, 8:00am - 4:30pm CST
• Please know hours of operation are 8:00am 6:00pm CST so shift could flex based on business need.
• Fully Remote
• Customer Service in Dental or Health Insurance experience a plus!

What will YOU be doing for us?

Increase member, provider and client use of our web based solutions for claims submission, payments, and authorizations.

What will YOU be working on?

• Provide education to callers on the benefits of utilizing the member and provider insurance portals.
• Service dental, medical, vision and physical therapy members and providers using the member and provider portals offered by SKYGEN USA.
• Provide feedback to multiple internal departments regarding issues found on the member and provider portals.
• Ensure all calls are answered according to company and client guidelines.
• Accurately document call information and resolution in internal systems while engaging with members and providers.
• Properly identify potential issues that are not easily resolved and escalate appropriately to Manager.
• Perform outbound calling projects as directed.

Additional Responsibilities:

• Utilize multiple modules in the Enterprise System to research portal questions.
• Work with internal departments to produce, maintain, and deliver portal training references and materials.
• Work with call center to resolve outstanding follow ups generated from incoming calls.
• Using automated systems, maintain updated data on portals by verifying accuracy and handling any exceptions or issues.
• Act as a liaison between portal users and clients to resolve escalated issues.
• Provide recommendations on system enhancements and process improvements to management.
• Assist department with administrative tasks and additional duties as needed.

What qualifications do YOU need to have to be GOOD candidate?

• Required Level of Education, Licenses, and/or Certificates
• High school diploma/GED required
• Required Level of Experience
• 1 year of customer service experience (Call Center, Provider Relations).
• Required Knowledge, Skills, and Abilities
• Intermediate knowledge of Microsoft programs (Word, Excel, and email)
• Excellent attention to detail
• Excellent oral and written communication skills
• Ability to successfully meet timelines for project plans
• Strong navigation skills and the ability to multi-task

What qualifications do YOU need to have to be a GREAT candidate?

• Preferred Level of Education, License, and/or Certificates
• Associates degree/2 year degree in related field
• Preferred Level of Experience
• 1-3 years of customer service experience (Call Center, Provider Relations).
• Preferred Knowledge, Skills, and Abilities
• Knowledge of contract terminology
• Understanding of reimbursement methods
• Knowledge of dental, medical, physical therapy and vision products and terminology

Job Info

• Job Identification 3261
• Job Category Customer Facing
• Job Schedule Full time
• Locations United States (Remote)
• Pay Range $15.61 - $23.41