As a Customer Service Representative II at SummaCare insurance company, I am responsible for fielding several member calls daily. These calls generally stem from member's benefit, eligibility, claims and billing questions.
SummaCare carries four main insurance product lines: Medicare, Self-Funded, Commercial, and the Healthcare Exchanges. Each line of business has specific benefit plans and eligibility processes that I am required to extensively research in order to confidently advise members. As a level two representative, I take calls from all lines of business, and occasionally train other representatives on our various product lines.
In my phone training, I have been formally certified in the principles of M.A.G.I.C. (Make a Great Impression on the Customer,) and consistently score 90% or higher on all monthly eligibility and service audits.
My position requires a large volume of outbound work as well. During this time, I am required to extensively document all incoming and outgoing phone calls and research complex issues regarding our self-funded clients. I also preform extensive administrative tasks including filing and routing call documentation, communicating with other departments, and maintaining meeting schedules.