Customer Service Representative
262 Washington Street Boston, MA 02108
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.
- 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.