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Healthcare Call Center Representative

Maryland Heights, MO 63043

Posted: 09/19/18 Industry: Customer Service Representative Job Number: 46945

HireLevel powered by Extra Help is hiring for a Healthcare Call Center Representative in Maryland Heights, MO!

Our client is looking for exceptional customer service representatives interested in growth and career opportunities!

Job Category: Contract to Direct, Full-time

Shift: 8am-5pm and 11am-8pm, Monday - Friday

Pay Rate: $14-$16 an hour DOE

Similar Positions: Customer Service Rep, Call Center, Benefit Specialist

Job Responsibilities of the Healthcare Call Center Representative:
  • Directly respond to questions, handle issues and provide guidance on transactions, inquiries or complaints from both internal and external customers, including members and providers.
  • Receive, document and resolve customer inquiries by using established best practices.
  • Educate members and providers about healthplan products and services over the telephone.
  • Receive training for Utilization Management and Claims as part of Career Path to reach level of Universal Representative for the company s future-state organizational goals.
  • Respond to complex customer calls.
  • Resolve customer service inquiries which could include:
    • Benefit and Eligibility information
    • Billing and Payment issues
    • Customer material requests
    • Physician assignments
    • Authorization for treatment
    • Explanation of Benefits (EOB)
    • Utilization Management protocols
    • Claims
  • Must be able to handle volatile situations and act urgently when necessary.
  • Must be willing and able to work flexible hours, including some weekends during seasonal times of the year and overtime when needed.
  • Makes outbound calls to any source needed to resolve open issues including but not limited to members, providers, pharmacies, hospitals etc.
  • Issue form letters & forms, when appropriate.
  • Investigates and respond to general correspondence, which may result in a variety of additional actions.
  • Must have strong investigative, problem solving skills.
  • Must be very detailed oriented and organized.
  • Ability to read and comprehend instructions in a very changing environment.
  • Ability to interact cross functionally across the company to resolve issues.
  • Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications.



Job Requirements of the Healthcare Call Center Representative:
  • High school diploma or general education degree (GED).
  • Minimum of 2 years Customer Service.
  • Proficiency in all Microsoft Office Programs, including Word, PowerPoint, Excel, and Access.
  • Ability to type 30-45 wpm.
  • Prior healthcare Customer Service & Claims adjudication experience in the healthcare field along with working knowledge preferred.
  • Must meet client s background and drug screening

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