Customer Service Representative
Word & Brown Companies 8 reviews - Orange, CA

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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. Departmental standard requires each Customer Service Representative to provide Service of Unequalled Excellence to all callers. Answer at least 100% of the daily call volume average. Provide clear and explicit documentation while maintaining percentage at a level of 90% or higher daily. Make busy time of 30 minutes or less per day.

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.

About this company
8 reviews
We've committed ourselves for nearly three decades to delivering Service of Unequalled Excellence to our clients. We pride ourselves in...