Client Services Representative

HealthOne Alliance•Dalton, GA

1d•Onsite

About The Position

The Client Services Representative addresses inquiries, questions and concerns in all areas including enrollment, eligibility, claims, benefit interpretation, and referrals/authorizations for medical care. The position is responsible for receiving, responding to, and directing member, broker and provider phone calls and other communications and provides available information upon request and escalates issues as appropriate.

Requirements

Requires a high school diploma or its equivalent
Ability to learn quickly and be self-motivated
Customer service experience preferred
Confidentiality and time management skills
Bilingual preferred
Knowledge of healthcare billing, claims and insurance a bonus

Responsibilities

Receives client calls or inquiries, which include potential/current/previous members, brokers and providers, and routes appropriately
Provides timely and accurate information to clients
Processes client requests according to established department policies and procedures
Completes research and investigative activities to address client inquiries
Works closely with other departments to gather information
Provides timely feedback to clients through outbound calling, email, mail or fax
Provides timely feedback to the company regarding service failures, systemic issues or client concerns
Assists in the completion of special projects
Assists in the documentation, evaluation and revision of department policies and procedures
Meets or exceeds service level agreements in call center metrics
Attends and participates in meetings and trainings as required
Regular and predictable attendance
Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
Maintains regular and predictable attendance
Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
Works to encourage and promote Company culture throughout the organization
Other duties as may be assigned