Job Description

POSITION PURPOSE:

This position will interact with members and providers, addressing inquiries, eligibility verification, communicate accurate plan benefits, resolve concerns and generally providing a high level or customer support on behalf of our benefit plans and programs with the ability to interact professionally, patiently, and courteously over the phone and in person at all times.

ESSENTIAL FUNCTIONS:

• Work efficiently in a high-volume call center while maintaining a professional, team-oriented, positive, and caring demeanor.
• Assist callers with benefit-related questions/concerns and provide accurate interpretation of claims and Plan benefits.
• Maintain accounts and records of membership and interactions with details of inquiries, complaints, and comments.
• Work efficiently in multiple systems simultaneously while effectively utilizing critical thinking and problem-solving skills.
• Maintain confidentiality and project a professional business presence and appearance.
• Performs other related duties as assigned.

QUALIFICATIONS:

• Service-oriented.
• Excellent verbal and written communication skills, including active listening.
• Customer service experience preferred.
• Knowledge of Medical Terminology and health benefits is preferred.
• Proficient computer skills with the ability to learn new software.
• Organized with attention to detail.
• Ability to multitask and work independently with minimal supervision.
• High school diploma or equivalent.

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