Customer Service Representative, Healthcare
About The Position
The Customer Service Representative (CSR) is responsible for providing effective customer service to members, providers, and other authorized representatives. The CSR responds to health plan inquiries, answering questions regarding plan benefits, claims, billing, and eligibility. This position requires excellent telephone oral and written communication skills, and attention to detail when documenting applicable call notes. The Customer Service Representative team handles roughly 120 to 190 inbound calls per day from both members and healthcare providers. Core daily tasks include: Verifying member benefits and eligibility. Providing claim status updates. Providing status updates for prior authorizations.
Requirements
- High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required
- Experience with Excel
Nice To Haves
- 1 year of commercial health plan or insurance experience preferred
- Experience providing customer service in a health care environment preferred
- Trizetto / QNXT software experience preferred
- Previous TPA experience is preferred (the position will support TPA services).
Responsibilities
- Providing effective customer service to members, providers, and other authorized representatives.
- Responding to health plan inquiries, answering questions regarding plan benefits, claims, billing, and eligibility.
- Documenting applicable call notes with attention to detail.
- Verifying member benefits and eligibility.
- Providing claim status updates.
- Providing status updates for prior authorizations.
Benefits
- Free Continuing Education and certification
- Tuition reimbursement, education programs and scholarships
- Vacation time starts building on Day 1, and builds with your seniority
- Free money toward retirement with a 403(b) and matching contributions
- Great food options with on-demand ordering
- Free parking and electric charging
- Commitment to diversity and inclusion
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
