Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
The Customer Service Representative I provides support to providers and members by answering calls regarding eligibility, benefits, claims, and service authorizations.
The Customer Service Representative I job description is intended to point out major responsibilities within the role, but it is not limited to these items.
1. Answering incoming calls from providers and members
2. Provides eligibility, claims and authorization status
3. Retrieves voice mails and responds
4. Collaborates with internal and external partners to resolve issues from providers or members as they relate to claims payment, authorization and eligibility inquiries
5. Creates, tracks and completes Customer Service Incidents to internal departments to resolve caller issues
6. Participate in the discovery and resolution of root cause for recurring issues
7. Ensure that all customer needs and problems are properly communicated and managed in a way that maintains great customer relationships
8. Use customer service best practices to ensure a positive customer experience
9. Meets daily, weekly, monthly metrics as written
10. Other duties and responsibilities as assigned
This position does not have supervisory responsibilities.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
• High School diploma or GED required
• One (1) to three (3) years in the Health Insurance Industry preferred
• One (1) to three (3) years of customer service experience required
• Claims payor experience preferred, but not required
• Strong communication skills, both verbal and written
• Organized and able to prioritize work to meet deadlines
• Able to work independently with little supervision
• Able to thrive in an often-chaotic environment
• Able to understand regulatory and compliance rules
• Results and detail oriented
• To be positive and accountable
• Team unity
• Most work responsibilities are performed in an open office setting, carrying out detailed work sitting or standing at a desk/table and working on the computer.
We’re Making Healthcare Right. Together.
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.