Customer Service Associate – Remote

By | August 1, 2022

Job Responsibilities : Customer Service Associate – Remote

Salary : $15 per hour

Company : Wipro

Location : Remote US

The remote CSR position interacts with customers to provide and process information in response to complex inquiries, concerns, and requests about health claims, coverage, benefits, and deductibles. Projects a professional company image and provides superior customer service by corresponding with Providers, Members, internal and external partners to proactively own the experience and resolve coverage issues.

  • Thoroughly and completely document all customer interactions.
  • Educates Members and Providers on eligibility, benefits, claims payment, and authorizations.
  • Provides direction on the usage and benefits of self-service tools.
  • Resolve claim payment inquiries by researching and analyzing patient activity and determine appropriate action to be taken.
  • Adjusts claims data, when appropriate, to immediately resolve the inquiry and maintain first call resolution expectations.
  • Appropriately route inquiries to the necessary departments or individuals when resolution of the inquiry is beyond the span of control of this role and set follow ups.
  • Meet or exceed individual, department, and client specific goals. Assist providers by resolving coordination of benefits inquiries by analyzing patient activity (including enrollment, third party liability, and claims attachments).
  • Interpret and communicate accurate insurance coverage by having a comprehensive understanding of the process.
  • Meet or exceed individual and department goals.
  • Understands and adheres to all of the client’s administrative and contractual policies and procedures.
  • Takes ownership of the resolution and sets expectations for follow up.
  • Other duties as assigned.

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