Senior Customer Service Representative

Job Description

REQUIREMENTS

• High School Diploma / GED OR equivalent experience
• Must be 18 years of age OR older
• 6+ months of work at home experience
• 6+ months of Customer Service Representative (CSR) experience OR 1+ years of experience in an medical / standard office setting, call center setting, or phone support role
• Working knowledge with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Ability to work any of our full time (40 hours / week), 8-hour shift schedules during our normal business hours of 7:00 am – 8:00 pm CST or MST from Monday – Friday. It may be necessary, given the business need, to work occasional overtime.

RESPONSIBILITIES

• Review and research incoming healthcare claim calls from providers (doctors, clinics, etc.) by navigating multiple computer systems and platforms and verifies the data / information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Communicate and collaborate with providers to resolve issues, using clear, simple language to ensure understanding
• Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, and attendance
• Answer incoming phone calls from members and identify the type of assistance the customer needs (i.e., benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)

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