Customer Service Representative - Medicare

The Health Plan of West Virginia Inc • Wheeling, WV

34d

About The Position

The Customer Service Representative is responsible for answering phone calls in a prompt and courteous manner to achieve contractual obligations. Responsible for answering Member's and Provider's questions with a quick and accurate response. They are also responsible for timely completion of all correspondence and reporting functions associated with the Customer Service Department.

Requirements

• High School Graduate: prefer 1-2 years college with interest or concentration in health field.
• Strong ability to relate with a variety of people in a non-judgmental manner.
• Strong organizational, verbal and written communication skills.
• Possess some knowledge of the health care system.
• Personal Computer (PC) and Keyboard skills.
• Proper usage of the English Language.
• Courteous manner/even temperament.
• Excellent communication skills.

Nice To Haves

• Previous call center experience.
• Medical Terminology.
• CPT and ICD-9/ICD-10 Coding.
• Familiar with medical and hospital claims.
• Familiar with Prescription Coding (NDC).
• Familiar with Coordination of Benefits Ruling.

Responsibilities

• Takes an average of 40-60 calls daily.
• Has established adequate proficiency in using the application necessary to perform the functions of a Customer Service Representative.
• Maintains monthly monitoring score of 90% accuracy or above on the 17 Points of Excellence.
• Demonstrates a complete understanding of departmental policies and procedures.
• Able to perform assigned tasks with minimal supervision.
• Meets requirements on annual performance evaluation.
• Consistently displays a positive attitude and acceptable attendance.
• Increasing improvement in performance and job knowledge.
• Documents calls according to departmental guidelines.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees