Education, skills, and experience :
1. High School Diploma a minimum two years of college preferred.
2. Two (2) years experience with a Managed Care Organization preferred.
3. Two (2) years experience in the health care industry, preferably in public relations, Customer Service, or compliance/state & federal regulations preferred.
4. Comprehensive understanding of Benefits’ and Patient Rights is preferred.
5. Knowledge of Medical terminology required .
6. Excellent verbal and written communication skills required.
7. Must be able to type a minimum of thirty (30) wpm with ninety (90) % accuracy.
8. Proficient with Microsoft Word/Outlook and basic keyboarding skills required.
9. Working knowledge of ICD-9 and CPT coding preferred.
10. Must be able to work independently and with others in a multi-disciplinary team environment.
11. Strong problem solving, organizational and time management skills necessary.
12. Must be able to diffuse difficult situations.
13. Must be flexible in meeting the demands of all department operations.
14. Must be capable of multitasking.
15. Multilingual a plus.
The Customer Services Representative presents a positive image to Florida health Care Plans members at all times. This position answers calls from FHCP members related to inquiries, complaints, grievances, and appeals. Must be able to quickly research benefits, information about expenses, document conversation in Correspondence Unit Tracking System, perform a warm transfer if needed, and answer emails when assigned. Information must be accurate and professionally delivered.
Florida Health Care Plans - 22 months ago