As an Inbound Customer Care Representative, you will be answering inbound calls. You will deliver a unique customer service experience utilizing your effective questioning and listening skills to determine the customer's needs and concerns, and ensuring a high level of customer satisfaction. This will involve providing excellent customer service support and answering calls to properly handle account requests.
We are looking for individuals who combine excellent customer service and problem-solving skills with the ability to function effectively both as part of a team or on an individual basis. You should also have time-managment and organizational skills necessary to effectively manage multiple expectations in a fast-paced environment. It is also vital that you display exceptional verbal and written communication, interpersonal and active-listening skills.
- Follows Client and Plan claims processing guidelines, benefit structures, claims processing system procedures and carrier guidelines.
- Expedites problem files to appropriate department and performs routine follow-up until resolved. May include some follow-up to insurers, providers and agents.
- Ability to answer phones in a friendly, courteous and professional manner.
- Analyzing claim payment and explaining this to callers who need assistance in understanding their benefits.
- Document required information into the approrpiate documentation systems.
- Meeting adhearance and quality standards.
- Other duties as assigned.
- Prior health care experience helpful
- Must have analytical/problem solving capabilities
- Must be PC proficient
- Excellent oral and written communication skills
- Knowledge of Medical terminology, CPT codes and ICD 10 diagnosis codes preferred
