Customer Service Representative I

Versant Health•Dayton, OH

16d•$17 - $18

About The Position

The Customer Service Representative I responds to customer service inquiries including, but not limited to, benefit information and timely fulfillment of requests for Versant Health Membership, Providers and Client Representatives. Acting as a liaison with internal and external Versant Health business partners to provide an exceptional customer service experience.

Requirements

Minimum High School Diploma or GED
Minimum 1 year of related experience
Proficiency in Microsoft Office
HIPAA & Security Requirements
All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program.

Nice To Haves

Knowledge and experience in the insurance, health, or vision care industry preferred

Responsibilities

Responsible for providing exceptional customer service, while answering incoming Member and Provider telephone inquiries in a manner that is always respectful and courteous
Proficient use of proprietary systems to respond to customer inquiries and requests, adhering to defined customer service standards. (ex. knowledge of in/out of network co-pays, non-plan allowances/retail value as well as the various network relationships)
Act as a liaison coordinating efforts between, Member, Provider, Client Representatives and the manufacturing facilities
Flexibility in work schedule as business needs require
Ability to identify and perform requirements relative to specialty services (including but not limited to student proof, prior approval, medically necessary contacts, special voucher/authorization processing, and requesting enrollment cards as well as out-of-network requirements) and/or order entry
Shadow perspective associates and new associates during initial instruction. This involves providing feedback to the hiring management team and trainer
Ability to probe and identify the critical content of inquiries and route caller as appropriate. Achieve and maintain individual Key Performance Indicators (e.g. quality, adherence to schedule) at acceptable departmental levels while supporting organizational performance measures
Perform in adherence to the company core values including but not limited to privacy, confidentiality and proprietary company policies and procedures (i.e. HIPAA)
Participate in any/all training and educational activities necessary to fulfill at least the minimum requirements as specified within your departmental goals. This is in addition to the completion of any activities necessary for the maintenance of professional affiliations or organizational requirements
Responsibility for reviewing educational notifications and remaining current on procedural changes
Regular reliable attendance is required
Meet and/or exceed all performance expectations
Career opportunity with additional training in skills for higher level position which will be considered minimal qualifications should open positions become available
Other duties as assigned