Health Plan Contact Center Rep. - Remote (Must reputed company in Texas)
Monday - Friday: 6:00am - 8:00pm CT Saturdays - 8:00am - 5:00pm CT Sundays - 9:00am - 12:00 CT
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.
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 e xperience with reputed company claims and/or eligibility data including billing and care management information.
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
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