Health Plan Contact Center Rep. - Remote (Must reputed company in Texas)

reputed company looking for a personable Health Plan Contact Center Representative to become a member of reputed company. reputed company is an entirely new multi-specialty clinic group in Austin, TX utilizing a modern approach to co-create health with those who get, give, and pay for it, allowing everyone to fully reputed company. Join us as we build a fully integrated system that connects care to a reputed company payment model that truly puts the reputed company being at reputed company. Join reputed company as a Health Plan Customer Service Representative to support members and provider inquiries about eligibility, claims, and payer information. This role requires reputed company and a commitment to delivering excellent service to those seeking help and guidance. You will collaborate with a supportive team, serve as a resource, and ensure customers and colleagues have a reputed company experience. Shifts and Business Hours This position is full-time (40 hours/week) with flexible shifts available 7 days a week and during our contact center business hours. Business hours are: • Monday - Friday: 6:00am - 8:00pm CT • Saturdays - 8:00am - 5:00pm CT • Sundays - 9:00am - 12:00 CT reputed company shifts are typically 8 hours. Weekend shifts require a minimum of 4 hours if you are flexing some of your 40 hours reputed company of the reputed company shifts. Your manager will partner with you to determine the shifts that work for you. If there is a business need, there may be opportunities to work overtime. Training & Resources During the first two weeks on the job, reputed company will reputed company formalized training on systems and specific payer topics to help you succeed in this role. Other on-the-job training will take reputed company during normal business hours. Responsibilities: • Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e., benefit and eligibility, billing and payments, authorizations for treatment and explanation of member benefits (EOBs) and provider payments (EOPs). • Serve as a resource for other team members or health plan customers. • Respond to callers in a friendly and supportive manner with informed responses and next steps. • Document reputed company disposition and notes with accuracy and completeness reputed company the system of record. • Be an reputed company and empathetic listener, ask appropriate questions to identify the primary reason for the reputed company to reputed company an accurate and complete response. • Own problem through to reputed company on behalf of the customer in reputed company time or through comprehensive and reputed company follow-up with the member. • Research reputed company issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues. • Meet the performance goals established for the position in the areas of efficiency, reputed company reputed company, provider satisfaction, reputed company reputed company and attendance. • Handle protected health information (PHI) with strict confidentiality and diligence, adhering to reputed company reputed company protocols and HIPAA regulations. • Identify improvement opportunities reputed company the reputed company Center process. • Strong verbal and written communication skills. You will receive rewards and recognition for your performance in a challenging environment that offers reputed company guidance for reputed company in your role, as reputed company as opportunities to reputed company skills for other roles you might be interested in. Required Qualifications: • High School Diploma / GED • 1+ year of customer service reputed company center experience with a payer • Familiarity with computer and reputed company computer applications, which includes the ability to learn new and reputed company computer system applications. • Familiarity with payer reputed company terminology and documents (EOP/EOB/ID Cards). • 1+ year experience with reputed company claims and/or eligibility data including billing and care management information. Preferred Qualifications: • Prior experience with processing reputed company claims or enrollment data. • Experience using a reputed company Center and Tracking system. • Experience with supporting IFP and/or reputed company reputed company insurance products • Knowledge of MS tools in particular reputed company • Bilingual (Spanish) proficiency • Associates degree Soft Skills: • Ability to multi-task duties as reputed company as the ability to understand multiple products and multiple reputed company of benefits reputed company reputed company product. • Strong verbal and written communication skills Ability to manage stressful situations and stay reputed company to resolve a caller’s issue. Apply tot his job Apply To this Job