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Customer Service Representative 2

Zenith American Wallingford, CT

  • Posted: over a month ago
  • Full-Time
Job Description

Title:  Customer Service Representative 2 

Department: Service Center 

Position Type:    Non Exempt     Hours per Week: 35/40

Position Summary:

The Call Center Representative provides professional, courteous and outstanding customer service to our members by researching and answering questions, escalating complaints in a prompt and thorough manner.  This representative will handle a high volume of inbound calls and creates a positive experience for each caller. The Representative will listen to clients to understand the reason for their call, address all questions, escalate all complaints, and provide an accurate and efficient response.

This position requires the employee to learn all the claims and document platforms required to research, respond, and document the call. Calls are handled while typing all information required to adequately document the call, during the call. The customer base includes participants, union locals and providers regarding eligibility, benefits and claims status on multiple accounts with routine supervision. This position requires a high degree of confidentiality to operate in accordance with all company and legal requirements around protection of personal and medical information.

To be a successful Call Center Representative, you should be customer-focused, detail oriented, and efficient. You should be polite, reliable, knowledgeable, and adaptable.

"Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."

General Duties:

  • Provides customer service by responding to and documenting telephone and written inquiries.
  • Meets with participants to answer questions and resolve claims and/or eligibility issues.
  • Maintains current knowledge of assigned Plans and effectively applies knowledge in all job functions.
  • Updates eligibility as necessary.
  • Performs administrative and clerical tasks.
  • Consistently meets established performance standards and consistently demonstrates excellent attendance and punctuality.
  • Performs other related duties and special projects as assigned.

Minimum Qualifications:

  • Demonstrated ability to
    • Proficiently and actively engage in answering live member calls 6.5 to 7.0 hours a day.
    • Engage in active listening with callers, confirming or clarifying information and diffusing angry clients, as needed.
    • Become proficient in utilizing multiple databases, claims operating platforms, scripts, and tools appropriately understand and strive to meet or exceed call center metrics while providing excellent consistent customer service.
  • Maintain current knowledge of assigned Plans and effectively applies knowledge in all job functions.
  • The ability to learn and understand the services we provide our members, and our company policies.
  • Proficiency with computers, strong typing skills. The ability to talk and type.
  • Strong time management Skills
  • Adaptability and accountability.
  •  Consistently meet established performance standards and consistently demonstrate excellent attendance and punctuality.
  • Excellent organizational skills, attention to detail, and ability to effectively interact with others.

Additional Qualifications

  • High School Diploma or Equivalent required, college degree preferred
  • One year of experience in customer service and claims processing for all types of group health benefit claims; knowledge of benefits, claims adjudication principles and procedures, medical and/or dental terminology and ICD-9 and CPT-4 codes.

Zenith American Solutions

Real People. Real Solutions. National Reach. Local Expertise.

We are currently looking for a dedicated, energetic Customer Service Representative 2 with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.

Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before.

We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We're always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American!


Job Posted by ApplicantPro

Zenith American


Wallingford, CT
06492 USA



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