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Customer Experience Representative

Spherion
Madison, WI
  • Expired: over a month ago. Applications are no longer accepted.
Job Description

Spherion is recruiting multiple Customer Experience Representatives to join the team of our Madison, WI-based shared services client. This position is responsible for providing excellent service in response to requests or questions from client members/providers via phone. You will own and research calls to completion in order to ensure a high level of member and provider satisfaction.

Direct-hire with an amazing benefits package! Customer Experience Representatives may work from home following 4-6 weeks of onsite training.

Responsibilities:

  • Receive and respond to customer inquiries providing information about the member benefits, eligibility, claims processing, and requirements of the benefit plan
  • Inform customers about and facilitate the referral and preauthorization process
  • Contact, inform, and educate members regarding out-of-network inquiries, non-covered codes, or anything that could negatively impact the member experience and/or out-of-pocket costs
  • Ensure first call resolution through effective call handling and problem-solving
  • Determine the various policy provisions, guidelines, provider requirements and procedures, medical review, and other procedures that apply to services
  • Receive inquiries regarding preauthorization of medical and surgical services and provide appropriate plan benefit information; provide information regarding approvals and denials of preauthorization requests, or the status of authorizations
  • Provide complete and accurate information about ongoing and changing plans, benefits, network status, and preauthorization requirements
  • Access and research various information to provide complete, accurate answers and decisions to customers. Investigate and consider all facts and specific circumstances surrounding customer questions/concerns
  • Document each customer interaction in accordance with the department’s standards, monitor the types of inquiries received, and report trends and concerns to the supervisor/ manager
  • Identify complex or unusual cases that require referral to the Harmony Care Program
  • Improve service by recommending changes to current practices, identifying training needs, and assisting in the implementation of changes
  • Announce and transfer all callers to the after-call survey consistently

Skills & Qualifications:

  • High school diploma or GED required
  • Three years of experience working in a customer service position, handling customer service inquiries, or working in a call or customer care center that required interaction with customers in situations where the customer was not always satisfied
  • Knowledge of insurance terminology
  • Experience using personal computers including keyboarding skills and knowledge of Windows-based software with the ability to efficiently and effectively navigate between different computer programs
  • Excellent communication skills including the ability to appropriately listen, respond to and resolve issues for angry, distressed, and/or unreasonable callers
  • Ability to document complete and appropriate information into the online systems while speaking on the telephone
  • Ability to apply the terms of an insurance policy or contract to a set of circumstances to determine available benefits
  • Ability to accurately apply and perform mathematical functions, including addition, subtraction, multiplication, division, and calculating percentages
Company Description
Since 1946, Spherion has placed millions of talented individuals in rewarding administrative, clerical, light industrial, customer service, non-clinical healthcare and professional jobs. Filling a broad mix of flexible, temp-to-hire and direct hire positions, Spherion is a trusted recruiting and staffing partner to more than 3,000 companies nationwide.

Spherion

Why Work Here?
We find people jobs! We love what we do!

Since 1946, Spherion has placed millions of talented individuals in rewarding administrative, clerical, light industrial, customer service, non-clinical healthcare and professional jobs. Filling a broad mix of flexible, temp-to-hire and direct hire positions, Spherion is a trusted recruiting and staffing partner to more than 3,000 companies nationwide.

Address

Madison, WI
53713 USA

Industry

Business

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