Professional Employment Group is working with a healthcare insurance company in Maryland Heights that is seeking Customer Service Representatives to join their team. This is a contract to hire opportunity and the details outlining the job description are listed below:
Job Description Summary:
As a Customer Service Representative, you will: directly respond to questions, handle issues and provide guidance on transactions, inquiries or complaints from both internal and external customers. External customers would include members and providers. Receive, document and resolve customer inquiries by using established best practices. Build lasting relationships with members. Educate members and providers about products and services over the telephone.
Role and Responsibilities:
· Respond to complex customer calls.
· Resolve customer service inquiries which could include:
- Benefit and Eligibility information
- Billing and Payment issues
- Customer material requests
- Physician assignments
- Authorization for treatment
- Explanation of Benefits (EOB)
· Must be able to handle intense situations and act urgently when necessary.
· Must be willing and able to work flexible hours, including some weekends during specific times of the year and over time when needed.
· Makes outbound calls to any source needed to resolve open issues including but not limited to members, providers, pharmacies, hospitals etc.
· Issue form letters & forms, when appropriate.
· Investigate and respond to general correspondence, which may result in a variety of additional actions.
· Must have strong investigative, problem solving skills.
· Must be very detailed oriented and organized.
· Ability to read and comprehend instructions in a very changing environment.
· Ability to interact with other department’s i.e. Enrollment, medical management in resolving issues.
· Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications.
Experience, Qualifications and Education:
· High school diploma or general education degree (GED).
· Proficiency in all Microsoft Office Programs, including Word, PowerPoint, Excel, and Access.
· Prior Customer Service & Claims adjudication experience in the healthcare field preferred
That translates into a winning solution for our customers and our job seekers. And it saves time, money and stress for everyone. Whether for temporary or permanent positions, Professional Employment Group is committed to providing our customers and our candidates with total satisfaction.
Our relentless pursuit of the ideal candidate for each role sets the gold standard for our industry.