Customer Service Jobs from Home Latest Vacancy 2022 Apply

Job Responsibilities 

• Respond to telephone written and electronic inquiries from employees/members providers clients and other interested parties using system notes plan documents and booklets benefit reference documents Claim Reference Manuals and claims-related memoranda.
• Treat all inquiries professionally and respectfully following Health Benefits guidelines
• Appropriately refer or escalate calls based on customer service procedures and guidelines.
• Research inquiries and respond appropriately.
• Appropriately refer unresolved inquiries or inquiries requiring further action to the appropriate individual e.g. Analyst Corrections Senior and Supervisor/Manager.
• Follow-up regularly on outstanding issues to ensure timely resolution and client satisfaction.
• Thoroughly and accurately document all inquiries using PowerSTEPP and Family Files following Health Benefits guidelines.
• Communicate via telephone email electronic messaging fax or written letter with employees/members providers of service clients and/or other insurance carriers to ensure proper claim processing and issue resolution.
• Initiate outgoing calls or other service projects as assigned.
• Other duties as needed/assigned

Job Qualifications:

• Previous customer service experience is required.
• Ability to work in a fast-paced customer service driven environment
• Excellent verbal and written communication skills are required.
• Ability to work effectively with team members employees/members providers and clients
• Ability to use common sense understanding to carry out instructions furnished in oral written or diagram form.
• Flexible; open to continued process improvement
• Ability to learn new/proprietary systems to adapt to various system platforms and to effectively use MS Excel/Word.
• Prior experience in a fast-paced call center is strongly preferred.
• Must be able to work a flexible 37.5 hr. work week that includes holidays rotating Saturdays and possibly Sundays.
• Applicants must have the flexibility to start as early as 6:00 am CST and be able to work as late as 8:00 pm CST. You will be provided with a set work schedule based on business needs.
• Self-Funded Insurance/Benefits and/or TPA experience a plus.
• Knowledge of medical procedure diagnosis coding and medical terminology preferred.
• Bilingual preferred.
• Familiarity with Summary Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive tools a plus.