About the Role:

• The Customer Service Representative is responsible for answering member, provider, and broker inquiries related to product information, benefits, claims resolution, eligibility, and billing questions in a call center environment.
• The role involves providing information and education to members, providers, and brokers about health, financial, and self-service programs, as well as offering basic technical assistance for digital and electronic applications.

Pay Range: $22- $24

Responsibilities: -

• Provide first-level problem resolution for member, provider, and broker inquiries via telephone by gathering and researching information, examining claim submissions, and verifying claim and system accuracy.
• Use knowledge of products or services to provide customer information service, interpret contractual language, determine benefit utilization and limitations, and administer services to customers within the business segment.
• Prioritize workflow and multitask efficiently in a fast-paced environment using multiple skill sets.
• Deliver accurate information to customers in accordance with performance goals and objectives.
• Maintain customer advocate records, identify underlying customer needs, and guide them to appropriate resources or programs.
• Participate in ongoing education related to new services, industry topics, and skills.

Education Qualification: -

• High School Diploma or GED - 3 years of customer service experience

Required Skills: -

• Demonstrated skills as an empathetic and compassionate communicator
• Ability to quickly gain customer trust and confidence
• Demonstrated PC navigation and data entry skills
• Strong interpersonal communication skills
• Good oral and written communication skills
• Ability to work effectively in a fast-paced environment with changing priorities and deadlines
• Ability to meet established deadlines and handle multiple customer service demands from internal and external customers