Call Center Representative - Medical Insurance

Call Center Representatives will provide all participants, local unions, providers, vendors and other customer service representatives extraordinary service when he or she is communicating with them via telephone, email, in person and other written correspondence. During each communication, you'll be expected to  provide empathetic and efficient service. 

DUTIES AND RESPONSIBILITIES 
• To obtain and maintain a working knowledge of the basic plan provisions and multiple benefit schedules, as well as a clear understanding of the eligibility system, claim system, and the Reciprocity system (ERTS) 
• Respond timely and accurately to phone calls, e-mail, walk in participants, and correspondence by answering questions; explaining claim payments and claim denials; quote self-payment amounts; verify eligibility and/or benefits; research eligibility or claim issues; update eligibility with outside vendors • Document all phone calls in the Customer Service module 
• Perform various clerical duties (i.e., enter enrollment forms; process working spouse forms, process special fund claims; process disability claims, etc.). 
• Navigate and provide accurate information  
• Monitor incoming calls and calls waiting via call management system 
• Pick up and handle messages from nightline 

REQUIRED AND PREFERRED KNOWLEDGE, SKILLS, AND ABILITIES 
• 1+ years of call center experience in a medical billing or medical insurance call center environment or 1+ years of processing medical claims 
• Bilingual speaking candidates strongly preferred 
• Bachelor’s degree or equivalent experience required 
• Previous TPA or major insurance carrier experience strongly preferred
• Excellent written & verbal communication skills 
• Proficiency in MS Office is required 
• Must type 40 wpm 
• Demonstrates ability to manage complex issues while maintaining a flexible, positive, and cooperative demeanor 
• Responds in a timely manner to operations leaders and stakeholders to facilitate informed decision-making 
• Troubleshoots assigned issues, gathers evidence, and investigates all relevant information with participants, vendors, and internal departments to resolve the problem in a calm and collaborative manner 
• Dependability – ensures timely arrival and consistent attendance to support the achievement of the team's goals.
• MUST be able to pass a required assessments (MS office, grammar and customer service)
•MUST be able to handle high call volume
•MUST be able to work 100% on-site
•MUST be able to commit to a 6-month starting September

Schedule: Mon-Fri (8a-5p)