Customer Service Representative

Boston, MA 02108

Employment Type: Contract To Hire Job Number: 6598

Job Description

We are looking for a professional and responsible person to join our clients team at a busy healthcare organization in Hingham, Ma!  The right candidate must be able to work quickly and accurately handle confidential information.


Responsibilities include:
  • This position is purely customer service in a call center atmosphere. 
  • Candidates are responsible for providing accurate and thorough information on insurance benefits, claims, eligibility and policies to members, prospective members and internal customers.
  • They will provide resolution of customer inquiries, facilitation of problem resolution, and will meet or exceed the customer' s expectation by addressing all of their issues or concerns.

They will also be responsible for the following:
  • Responds accurately to provider inquiries regarding policies, procedures, benefits, claims, and eligibility.
  • Possesses thorough knowledge of policies, procedures, benefits, eligibility, and claims.
  • Interacts with other staff, particularly in the areas of Claims, Fee and Reimbursement, Allied Health, and Network Contracting to resolve customer inquiries and problems. 
  • Efficiently accesses all resource materials needed to effectively and accurately interpret, respond, and resolve customer inquiries and concerns. 
  • Demonstrates basic understanding of billing guidelines and can effectively interpret and correct misunderstandings related to claims.
  • Accurately logs all calls in with appropriate inquiry and reason codes and documents comprehensive memos regarding each customer interaction.
  • Investigates and adjusts claims to ensure problem resolution and minimize repeat calls.
  • Adheres to assigned schedules to ensure proper phone coverage, which contributes to optimal service levels for the call center.
  • Considers and proposes creative alternatives to difficult problems.
  • Understands how to utilize internal resources to resolve an issue or make a decision regarding a policy or guideline.
  • Independently resolves issue with attention to detail, and in cooperation with other departments.

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