The role of Customer Service Representative (Level 2) is primarily responsible for providing attentive customer services to providers. Responsibilities include answering routine inquiries, resolving issues, and delivering exceptional customer experiences.
Using top-notch interpersonal skills, being able to understand customers' inquiries or complaints and deal effectively with callers who may be frustrated or angry.
Handling inbound calls/outbound calls, voicemails, and emails from providers regarding a variety of requests related to benefits, eligibility, network/authorizations, claims inquiry, claims escalations and reconsiderations / appeals.
Navigating multiple databases simultaneously to research and create resolutions for providers.
Possess a professional and friendly attitude and be able to quickly develop a rapport with customers over the phone.
Identifying, researching, and resolving customer issues using different databases.
Follow-up on customer inquiries not immediately resolved.
Consistently meeting established performance and quality standards.
Participate in recommended or required continuing education seminars and training sessions as needed.
Collaborate with other areas regarding call center related functions, inquiries, or issues.
Participate in special projects as requested.
Follows all Policies and Procedures and HIPAA regulations.
Customer service experience in a call center environment of 18 to 24 months – with a Healthcare focus - Medicare/Pace/Claims knowledge preferred.
Familiarity with cloud-based contact center software is desirable.
Strong personal computer usage and internet proficiency skills. Having Microsoft Excel knowledge is an added advantage.
Strong work ethic and self-starter, able to effectively manage multiple priorities and adapt to change within a fast-paced call center environment.
Ability to learn and navigate new software quickly.
Flexible scheduling as business needs dictate.
Communicate by way of the telephone with participants, customers, vendors and staff.
Operate a computer and other office productivity machinery.
Visual acuity to perform activities such as identifying, inputting and analyzing data on a computer terminal and/or in hard copy.
This job is operated in a professional office setting with a conversational noise level.
Group Medical Insurance
Office Transport
Shift Timings: US Shift – 8AM to 5PM (EST, CST, MST, PST).