Customer Service Representative

Harris Computer•Washington, NV

5d•$17•Onsite

About The Position

eNoah, a Harris Computer company, is seeking a Life and Health Claims Customer Service Representative. In this position you will examine, perform research and make the decisions necessary to properly adjudicate telephone and written inquiries. Interpret contract benefits in accordance with specific claims processing guidelines. Communicate problems identified relevant to the claims processing system to the appropriate people. Receive, organize and make daily use of information regarding benefits, contract coverage, and policy decisions. Maintain external contacts with policyholders, providers of service, agents, attorneys and other carriers as well as internal contacts with peers, management, and other support areas with a positive and professional approach.

Requirements

Life and Health Claims experience
Ability to examine, perform research and make decisions for claim adjudication.
Ability to interpret contract benefits.
Ability to communicate problems with claims processing system.
Ability to organize and utilize information regarding benefits, contract coverage, and policy decisions.
Ability to maintain external contacts with policyholders, providers, agents, attorneys, and other carriers.
Ability to maintain internal contacts with peers, management, and other support areas.
Ability to interpret contract benefits accurately.
Ability to provide claim status.
Ability to answer calls professionally and timely.
Ability to place outgoing calls to obtain or provide information.
Ability to document calls.
Ability to transfer calls to appropriate departments.
Ability to document policy files clearly and concisely.
Ability to participate in cross-training and group training.
Ability to communicate openly with Supervisor, Team Lead, and team members.

Responsibilities

Examine, perform research and make the decisions necessary to properly adjudicate telephone and written inquiries.
Interpret contract benefits in accordance with specific claims processing guidelines.
Communicate problems identified relevant to the claims processing system to the appropriate people.
Receive, organize and make daily use of information regarding benefits, contract coverage, and policy decisions.
Maintain external contacts with policyholders, providers of service, agents, attorneys and other carriers as well as internal contacts with peers, management, and other support areas with a positive and professional approach.
Interpret contract benefits accurately to policyholder, agents, and providers with a positive and professional approach.
Provide claim status to policyholders or providers with a positive and professional approach.
Answer calls as required by company policy in a helpful, professional, timely manner.
Place outgoing calls as needed to provide or obtain information.
Document (written/on-line) all calls while in progress.
Transfer calls to employees in other departments as required to meet customer needs.
Fully document policy file or imaging system with all related material so as to leave a clear and concise audit trail.
Actively participate in cross training and group training sessions to maximize team efficiency and maintain or exceed service standards.
Communicate openly with Supervisor, Team Lead and other team members to ensure accurate responses and avoid duplication of efforts.