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
- 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