Job Summary:
We are seeking an experienced Call Center Representative with a background in handling medical insurance. The ideal candidate will have excellent communication skills, a strong understanding of medical insurance processes, and the ability to provide exceptional customer service in a fast-paced environment.
Key Responsibilities:
- Handle inbound and outbound calls related to medical insurance inquiries, claims, and billing.
- Assist patients, providers, and insurance companies with questions regarding insurance coverage, benefits, and eligibility.
- Process insurance claims, authorizations, and referrals accurately and efficiently.
- Resolve customer complaints and issues with professionalism and empathy.
- Maintain detailed and accurate records of customer interactions and transactions in the database.
- Provide information and guidance on insurance policies, procedures, and regulations.
- Collaborate with other departments to ensure seamless customer service and issue resolution.
- Stay up-to-date with changes in insurance policies and procedures to provide accurate information to customers.
Qualifications:
- Must have 1 year or more of experience in a medical insurance call center environment. Specifically, a candidate who has worked for Aetna, Blue Cross Blue Shield, UHC, Kaiser, or any other medical insurance plan.
- High school diploma or equivalent; Associate's or Bachelor's degree preferred.
- Minimum of 2 years of experience in a call center or customer service role, with a focus on medical insurance.
- Strong knowledge of medical insurance terminology, processes, and regulations.
- Excellent verbal and written communication skills.
- Proficiency in using customer service software and databases.
- Ability to multitask and manage time effectively in a fast-paced environment.
- Strong problem-solving skills and attention to detail.
- Ability to work independently and as part of a team.
- Bilingual skills (preferred but not required).
