About the job
As a Customer Service Representative in the Healthcare sector, you will handle both inbound and outbound calls to address specific inquiries, common questions, and aim for one-call resolutions for health share members and providers. You will collaborate with various departments to ensure that accurate health share information is provided in accordance with the Membership Guidelines.
Key Responsibilities:
- Respond to incoming calls from members and providers, and conduct follow-up outbound calls as necessary.
- Resolve general inquiries from members and providers through phone or email communication.
- Identify issues that require escalation and take appropriate actions.
- Document and report trends or operational problems, notifying management when necessary.
- Deliver precise health sharing information and services to members and providers.
- Collect and review medical records as needed.
- Maintain up-to-date member information and eligibility status.
- Clearly explain eligibility details to both members and providers.
- Demonstrate a willingness to learn and adapt.
- Ensure exceptional customer service is provided at all times.
Required Skills:
- Strong critical thinking and problem-solving abilities
- Self-motivated and goal-oriented
- Exceptional written, verbal, and interpersonal communication skills
- Able to work independently and collaboratively in a team setting
- Proficient computer skills with a good working knowledge of Microsoft Outlook
- Excellent phone etiquette and customer service capabilities, as the role primarily involves phone communication
- Familiarity with medical policies, procedures, and HIPAA regulations
Qualifications:
To succeed in this role, candidates must fulfill the essential duties satisfactorily. The following qualifications are necessary:
- High School Diploma or GED is required
- Minimum of 1 year of customer service experience is required
- Experience in the healthcare field, particularly in reviewing or verifying medical records, is preferred
- An Associate’s degree or higher is preferred
Technical Skills:
- Proficient in Google Suite, including Share Drives and Email
- Experience with call center software and operating systems
- Familiarity with Salesforce is a plus
Benefits:
- Health Maintenance Organization (HMO) coverage with one dependent free upon hire
- Life Insurance coverage
- 10% Night Differential pay
- 20 PTO credits annually
- Cash conversion for Vacation Leave (VL) and Sick Leave (SL)
- Annual performance-based merit increases and employee recognition programs
- Positive company culture
- Opportunities for career growth and learning