Important things YOU should know:
Fully remote opportunity
Training schedule 8:00am - 4:30pm Monday – Friday CST for the 1st 3 weeks
Work schedule (after training): Multiple opportunities available with
ranging start times from 9:00am CST to 11:00am 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.
SKYGEN is the trusted partner for specialty benefits payers and government
agencies responsible for the delivery and administration of dental and vision
benefits. Through cutting-edge technology and service solutions, SKYGEN empowers
clients to become the most efficient, effective healthcare organizations in the
country.
Equal Opportunity Employer, including Protected Veterans and Individuals with
Disabilities.