The Customer Service Call Center Representative is responsible for assisting members and clients with service inquiries, claim status and interpretation of plan descriptions and plan documents via the telephone.
Customer Service Functions:
· Develop and strengthen relationships with members and clients through phone contact and call resolution.
· Service up to100 calls per day.
· Provide benefits, status and claim inquiry to callers.
· Effectively utilize all customer service tools available.
· Take an active role in claims and customer service meetings.
· Medical/HRA/HSA/Dental/Vision/Flex/STD self-insured knowledge is essential
· Benefit interpretation knowledge of a Summary Plan Description and a Plan Document.
· Support the Operations Service team as it relates to mutual goals of the company.
· Complete all requested inquiries of the Claims/Customer Service Area.
· Assist Account Managers with client service inquiries, when applicable.
· Other duties as assigned.
· Demonstrated excellent communication skills, both verbal and written.
· Preferably 3-5 years’ experience in the healthcare/insurance field which would require knowledge of medical insurance terminology.
· Professional phone voice and superior attitude is required.
· Excellent attendance record
Education and/or Experience
· Minimum 1-year experience within a medical insurance call center where customer service and the overall member experience is the priority.