Services our incoming callers (providers/members) for all lines of ASO business in a clear professional and accurate manner. Documents all calls and intakes utilizing good written communication skills. The representative demonstrates the ability to multitask and follow through. Must effectively communicate to our callers and to management to allow for proper problem solving and identifying of service problems and trends. Adjusts claims. Contributes to team goals in achieving organizational objectives. Must be accountable for their end work product.
Primary Job Duties:
- Arrive on time and be ready to go at start time. Be available for call taking majority of the day.Accountability -must take ownership of the calls/items they handle and hold themselves accountable for their own actions and to ensure that assurances given to callers are matched to end results. Need to ensure that their efforts are such that there was nothing more they could have done to ensure satisfaction on the part of the caller.Need to ensure that their efforts are such that there was nothing more they could have done to ensure satisfaction on the part of the caller. (10%)
- Achieve performance standards (quality, accuracy and productivity).Handle incoming calls within required speed of answer.Take sufficient number of calls on a daily basis and handle them accurately. Also accurately process and adjust claims and research claim benefit eligibility.Assist callers by explaining benefits in an accurate, clear manner while demonstrating outstanding verbal communication skills to our members/clients/providers and others outside our organization.Document intakes, generate letters demonstrating good written communication skills while expressing themselves in a clear and detailed manner to ensure that others viewing their work product can easily understand the situation involved.Problem solving - must know where to go to get the problem solved. Needs to know where in various systems information is located and must be able to independently research a problem and assist our callers in resolving problems.Maintain confidentiality and adheres to HIPAA regulations. (90%)
- Must meet minimum qualifications to perform work including satisfactory completion of training and testing
- Ideal candidate must be a problem solver and tactful when dealing with callers
- Demonstrate the ability to work and multi-task in a fast paced environment
- Displays excellent interpersonal skills and is a team player
- Ability to use PC and office equipment
- Working knowledge of Microsoft Office
- Must have good organizational and time management skills and be detail oriented
Some college preferred. 2 years insurance experience a plus, working in an inbound call center a plus.