Customer Service Representative
The Customer Service Representative is responsible for answering phone calls in a prompt and courteous manner to achieve contractual obligations. Responsible for answering Member's and Provider's questions with a quick and accurate response. They are also responsible for timely completion of all correspondence and reporting functions associated with the Customer Service Department.
- High School Graduate or equivalent.
- Strong ability to relate to all customers.
- Excellent communication skills.
- Some knowledge of health care and insurance.
- Computer and Keyboard skills.
- Proper usage of the English Language.
- Consistently displays a positive attitude.
- -2 year post high school education with focus on healthcare.
- Previous call center experience.
- Knowledge of medical terminology.
- Knowledge of CPT and ICD-10 Coding.
- Familiar with medical and hospital claims.
- Takes an average of 40-60 calls daily.
- Maintains monthly monitoring score of 90% accuracy or above on the 17 Points of Excellence.
- Demonstrates a complete understanding of departmental policies and procedures.
- Able to perform assigned tasks with minimal supervision.
- Meets requirements on annual performance evaluation.
- Increasing improvement in performance and job knowledge.
- Documents calls according to departmental guidelines.
The Health Plan of West Virginia IncWheeling, WV
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