Paramount Health Care, a ProMedica Health Plan, offers insurance products across six Midwest states. This Ohio-based company, headquartered in Toledo, has more than 685 employees dedicated to serving their health plan members. Paramount offers Medicare Advantage and Marketplace Exchange health plans for individuals and families. Paramount maintains accreditation by the National Committee for Quality Assurance (NCQA) for their HMO and Medicare Advantage products.In addition, Paramount has a full complement of insurance products for employers of any size, including medical, dental, vision and workers’ compensation, as well as vocational rehabilitation, life-care planning and wellness.As a part of ProMedica, Paramount is driven by ProMedica’s mission to improve your health and well-being. ProMedica has been nationally recognized for its advocacy programs and efforts to address social determinants of health. Paramount strives to provide an exceptional experience to every member. For more information about Paramount, please visit our website at paramounthealthcare.com.REPORTING RELATIONSHIPSPosition reports to Team Lead and does not have any direct reports.POSITION SUMMARYThe Call Center Specialist provides high-level customer service and effectively communicates with existing and prospective clients (dentists, members, agents, and employer groups) regarding claims, enrollment, and benefit service support. ACCOUNTABILITIESManages multi-line phone system
Provides excellent customer service support by taking client information, and responding to questions regarding claims, enrollment, and benefits information.
Proactively seek solutions and problem-solve to resolve client issues relating to plan information, enrollment, and client material.
Responsible for communicating guidance and directions to assist members in navigating benefit information online including directing clients to company website to verify enrollment, benefit coverage, and how to submit claims/pretreatments.
Communicate website capabilities efficiently and innovatively.
Collaborate with other call center representative to improve customer service
Other duties as assigned.REQUIRED QUALIFICATIONSEducation: High school diploma or equivalentSkills: Must have excellent interpersonal skills necessary to communicate effectively with callers, members, physicians, and other providers. Experience using Microsoft Windows and Microsoft Office programs is required. Demonstrated typing competency (minimum of 40 wpm). Must possess good organizational and priority-setting skills and exercise independent judgment with minimal guidance and supervision. Team-oriented and self-motivated with the ability to effectively prioritize and execute tasks in a high-pressure environment.Years of Experiences: One to two years of call center experience or comparable experienceLicense: NACertification: NAPREFERRED QUALIFICATIONSEducation: High School Diploma or GED requiredSkills: Strong knowledgebase of dental billing office practices, including practice management computer system experience
Demonstrate knowledge of ADA/CDT coding regulations and requirements Basic knowledge of insurance regulations.
Fluent in Spanish LanguageYears of Experience: Minimum of two years’ experience in telephone sales or telephone-based customer service or comparable experienceLicense: NACertification: NAWORKING CONDITIONSPersonal Protective Equipment: NAPhysical Demands:Sitting for extended periodsDexterity of hands and fingers to operate a computer keyboard, mouse, and phone for data entryProMedica is a mission-based, not-for-profit integrated healthcare organizational headquartered in Toledo, Ohio. For more information, please visit www.promedica.org/about-promedicaQualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact [email protected] Opportunity Employer/Drug-Free WorkplaceRequisition ID: 82705