Essential Duties and Responsibilities include the following. Other duties may be assigned.
- Answers telephone calls using the proper greeting.
- Listens to client’s issues and clarifies the question or problem the client needs to resolve their problem.
- Provides information necessary to resolve client’s inquiry or problem.
- Explains information in layman’s terms so that the client understands the information.
- Demonstrates a high degree of empathy and applies customer service techniques to de-escalate situations where the caller is extremely upset.
- Processes routine insurance changes such as adding dependent(s) or spouse, changing a doctor, and change of address.
- Researches appropriate documents such as Summary Plan Documents to quote benefit correctly.
- Researches information regarding claims.
- Logs all details into the system using proper notation during the call.
- Maintains a high degree of confidentiality and conforms to all applicable HIPAA provisions.
- Maintains excellent attendance and punctuality and adheres to schedule.
Knowledge, Skills, & Abilities:
- Ability to provide effective leadership in all aspects of position.
- Excellent written and verbal communication skills.
- Must be dependable and maintain excellent attendance and punctuality
- Strong analytical skills and problem solving skills.
- Subject-matter expert within field.
- Ability to keep up with changes in information to Plan documents in order to quote benefits correctly.
- Ability to grow with changing demands of the position and the company.
- Strong computer skills, including Word, Excel, Outlook, and Power Point.
- Call center experience in a medical/benefits environment highly preferred.
- Medical/Benefits Experience highly preferred.
- UR/Claims/COBRA/FSA/Eligibility Experience preferred.
Supervisory Responsibilities :
This job has no supervisory responsibilities.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience:
Associate's degree (A. A.) or equivalent from two-year college or technical school; and minimum of one year related experience and/or training; or equivalent combination of education and experience.
Ability to read, speak, and write effectively in English. Ability to interpret documents such as safety rules, memos, letters, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before customers or employees of organization. Ability to effectively address or resolve customer service issues within guidelines of the position.
Ability to add and subtract, multiply and divide with 10's and 100's.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
Certificates, Licenses, Registrations:
Valid, class C license in state working with no adverse driving record.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job, the employee is regularly required to sit for extended periods of time. The employee is frequently required to reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk and use hands to finger, handle, or feel. The employee may occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate.