Need At Least 1 Year Healthcare and 2 Years Call Center Experience
Training is Mon-Fri 8:30am - 5pm CT / Shift will be an 8-hour shift between Mon-Fri 8:30am - 5pm
Job Summary:
The Call Center Representative is a front-line service position aiding state benefit system members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims, and authorization of services from members or providers.
Responsibilities:
Available to work scheduled work hours based on operational needs
Accurately respond to inbound phone calls and processing provider and member inquiries
Under general supervision, resolve customers' service or billing complaints by demonstrating sound judgement
Contact customers to respond to complex inquiries or notify them of claim investigation results
Refer unresolved customer grievances, appeals, and claim resolution to designated departments
Keep records of customer interactions and transactions
Actively listen and probe callers to determine the purpose of the calls
Research and communicate information regarding member eligibility and claims status
Assume responsibility for self-development and career progression
Educate providers on how to submit claims and when/where to submit a treatment plan
Perform necessary follow-up tasks to ensure member or provider needs are completely met.
Support team members and participate in team activities
Must Have:
Experience with Microsoft Word and Powerpoint
2 years of Call Center Experience
1 year of Healthcare Experience