Customer Service Representative

Lehigh Valley Health Network•Allentown, PA

13d•Onsite

About The Position

Imagine a career at one of the nation's most advanced health networks. Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work. LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day. Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network. Summary Supports a positive service experience while handling member and provider inquiries via telephone, Customer Service portal, or written correspondence.

Requirements

High School Diploma/GED
2 years Call center experience and 2 years Insurance and/or claims administration experience
Ability to take the initiative to identify and carry out responsibilities to their completion.
High degree of professional judgement and inter-personal skills at all levels and among all disciplines.
Knowledge of insurance or claims administration.
Lift and carry 7 lbs., continuous sitting >67%, frequent keyboard use/repetitive motion, frequent fine motor activity/wrist position deviation.

Responsibilities

Performs ancillary customer service functions relative to claims, providers, recoveries, and forms or letter generations.
Uses multiple systems and screens to efficiently handle interaction.
Offers solutions that aid and facilitate a unique customer service experience, including First Call Resolution (FCR).
Anticipates needs; educates members and providers about related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc.
Engages caller to gather necessary information to guide through plan of benefits, answer questions regarding care needs, and resolve issues.
Interacts with customers, vendors, and colleagues professionally to ensure questions are answered accurately and in a timely manner.
Assists with billing questions, claim adjustments, FSA/HSA account, COBRA payments, etc.
Handles requests related to appeals and pre-authorizations.
Meets all quality and adherence standards.
Participates in team and individual discussions related to process improvement.