Job Location : Wheeling,WV, USA
The Customer Service Representative is responsible for answering phone calls in a prompt and courteous manner to achieve contractual obligations. Responsible for answering Member's and Provider's questions with a quick and accurate response. They are also responsible for timely completion of all correspondence and reporting functions associated with the Customer Service Department.
Required:
* High School Graduate or equivalent.
* Strong ability to relate to all customers.
* Excellent communication skills.
* Some knowledge of health care and insurance.
* Computer and Keyboard skills.
* Proper usage of the English Language.
* Consistently displays a positive attitude.?????
Desired:
* 1-2 year post high school education with focus on healthcare.
* Previous call center experience.
* Knowledge of medical terminology.
* Knowledge of CPT and ICD-10 Coding.
* Familiar with medical and hospital claims.
Responsibilities:
* Takes an average of 40-60 incoming calls daily.
* Keep pended work at tolerable range (when applicable).
* Manage to work correspondence, faxes and e-mails in a timely manner.
* Maintains monthly monitoring score of 90% accuracy or above on the 17 Points of Excellence.
* Demonstrates a complete understanding of departmental policies and procedures.
* Able to perform assigned tasks with minimal supervision.
* Meets requirements on annual performance evaluation.
* Increasing improvement in performance and job knowledge.
* Documents calls according to departmental guidelines.