Customer Care Rep II - Fully Remote!

Job description

Important things YOU should know: • Fully remote opportunity • Training schedule 8:00am - 4:30pm Monday - Friday CST for the 1st 12 weeks • Work schedule (after training): 10:30am - 7:00pm CST Mon - Fri • Hours of operation: 6:00am - 10:00pm CST Monday - Friday so shift could flex based on business need • $2.00/hour differential on Mon/Tues • Occasional evenings, weekends and holidays possible during Annual Medicare Open Enrollment: 10/1 - 3/31 • Exceptional professional growth in a fun rewarding environment • Experience with Dental or Health insurance a preferred plus What will YOU be doing for us? Our Customer Service Representatives must have strong problem-solving skills, coupled with the natural ability to provide empathy for the customer - always taking the time to patiently listen and understand their questions to help find a viable solution, while providing them with a memorable customer experience. What will YOU be working on every day? • Servicing our Dental and Vision inbound callers with information regarding their eligibility, benefit coverage, authorizations, claims, and assisting them with locating a provider in their area, • Utilize knowledge of claim adjustments and resubmission processes to determine appropriate resolution to provider requests. • Provide feedback to Provider Relations staff on high-level claim issues including but not limited to issues with reimbursement schedules or conflicting information to ensure providers receive a prompt resolution. • Support enrollment activities including but not limited to assigning primary care providers, and updating third party insurance information. • Act as liaison between our organization and the client's Member Services staff to resolve issues such as eligibility and filing appeals and grievances. • Provide updates to providers with questions regarding the status of their credentialing application. • Recognize provider questions that could be handled through the use of the provider web portal and provide education to these callers on the benefits of utilizing the technology available. • Ensure all calls are answered according to company and client guidelines. • Accurately document call information and resolution in our internal systems. • Apply effective diffusion techniques when necessary to ensure our customers feel heard, valued and supported. • Properly identify issues that need to be escalated appropriately to the leadership team. Additional Responsibilities: • Provide recommendations on system enhancements and process improvements to management. • Keep our Provider Relations team updated with provider manual discrepancies, change in locations or any other provider related issues. • Participate in departmental projects when applicable. What qualifications do YOU need to have to be GOOD candidate? Required Level of Education, Licenses, and/or Certificates • High school diploma or equivalent. • Required Level of Experience • 1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail. Required Knowledge, Skills, and Abilities • Basic knowledge of Microsoft Office products including but not limited to Word, Excel, and Outlook. • Ability to work occasional overtime as needed. • Excellent listening and communication skills. • Superior customer service skills including the natural ability to provide empathy. • Strong data entry/typing skills. • Strong navigation skills and the ability to multi-task. • Excellent attention to detail. • Critical thinking skills to quickly analyze and clearly understand a specific request or customer need and then leverage knowledge and resources to provide the appropriate solutions. What qualifications do YOU need to be a GREAT candidate? Preferred Level of Experience • 1+ years of job related customer service experience within the dental, vision or medical industry. • Previous experience working in a virtual environment. • Understanding of dental, vision and/or medical insurance terminology.