The Customer Service Rep Handles calls from customers to resolve, educate, follow-up and respond to questions regarding Choice Administrators plan administration and procedures.
• Answers questions by telephone from employers regarding new hires, billings, rates, supplies, administrative procedures, etc.
• Educates, via telephone, employees/dependents regarding PCP’s, ID cards, RX problems, administrative procedures, dependent coverage, address changes, etc.
• Follows-up on calls from brokers regarding problems that their groups are experiencing.
• Responds to calls from providers to confirm eligibility and benefits.
• Verifies enrollments and resolves issues with carriers.
• Expedites processing of members enrollment with carrier if urgent services are needed.
• Review and submit appeal requests from groups.
• Review /Audit group billing and explain to clients in clear and accurate manner.
• Document calls in call tracking system.
• Knowledge of and experience in the health care/insurance industry. At least 2 years of customer service experience required. Computer literate and word processing experience. Typing speed of at least 50 wpm. Ability to handle irate customers in a courteous, patient, calm and positive manner while maintaining a high quality and quantity of work. Experience in handling high call volume. Excellent professional verbal and written communication skills. High school diploma or equivalent. Must be able to sit 95% of the time, stand and walk 5% of the time. Close vision required. Must be able to hear phone conversations and verbally communicate to caller. Utilize fingers, hands & arms to feel and manipulate. Working environment is stable and noise level is moderate.