Client Services Representative-1

HealthOne Alliance•Dalton, GA

About The Position

MISSION Our mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors. VALUES HealthOne is guided by a cultural framework that embodies our values and drives our decisions. Our PURPOSE is to care for people by connecting them to resources that help protect them in health related situations. To fulfill our purpose, we align our PRIORITIES to ensure each decision we make is ethical, empathetic, economical, and efficient. We care for PEOPLE by being welcoming, authentic, truthful, consistent and humble. We are continuously looking for ways to improve our PROCESS and how we get things done. HealthOne seeks individuals with integrity and heart to embody our values. Whether you’re starting your career or looking to develop additional skills to reach your full potential, HealthOne provides the means to help you achieve your goals. JOB PURPOSE 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
Prolonged periods of sitting at a desk and working on a computer.
Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day responsibilities.
Must be able to drive a vehicle and daytime/overnight travel as required.
Drug Screen and Background Check Required

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