Customer Service Representative Health Insurance

Customer Service Representative Health Insurance

POSITION SUMMARY The Customer Service Representative (CSR) will provide voice-based customer support to participating providers of a health plan and members by successfully resolving or correctly routing their telephone inquiries. ESSENTIAL JOB DUTIES FUNCTIONS -Interprets and analyzes incoming customer inquiry calls and handle them efficiently and adequately.-Ability to independently and professionally handle a high-volume of incoming medical insurance inquiries and issues from members and providers and resolve efficiently or route the call to the right department.-Identifies routine calls and expedites escalated call issues to a more proficient team member or supervisor when unable to resolve a task.- Maintains performance and quality standards based on established call center metrics including turn-around times-Uses established tools and procedures to solve task-related problems such as verifying data and researching information.-Handles confidential information in accordance with HIPAA requirements. -Documents calls in accordance with departmental policies. -Employs strong interpersonal skills in order to handle difficult calls courteously and professionally. OTHER FUNCTIONS AND RESPONSIBILITIES - Interacts effectively with the Operations team business partners and internal departments. Actively participates in and contributes to the daily operations of the Customer Operations Department.- Identifies opportunities to improve processes and services. Shares with Customer Operations management issues that are obstacles to providing great service.- Performs other duties as assignedMINIMUM REQUIREMENTS LICENSES CERTIFICATIONS - High school diploma or equivalent required. - 1-3 years in a customer call center service preferably in healthcare or insurance environment- Effective and diplomatic oral communication skills. - Sound reasoning and problem solving skills.- Strong computer skills with Microsoft Office and a minimum of 40 WPM typing.- Ability to read understand and follow written policies and procedures.- Must be reliable and able to meet production and quality standards.- If you are a former NTT Data Dell Perot or CSRG employee you must be eligible for rehire PREFERRED QUALIFICATIONS - Experience in healthcare insurance industry preferred. Paid training is offered.- Associates degree technical college or some college course work preferred.