Note: The job is a remote job and is open to candidates in USA. Sunrise Systems is recruiting for a leading healthcare insurance company seeking a Customer Support 1 – Claims professional. The role provides customer support, processes claims, responds to member and partner inquiries, completes documentation, performs quality assurance testing, and resolves issues or complaints.
Responsibilities
- With general supervision, ensure accurate, timely, and efficient customer support
- Respond to customer inquiries in a manner that supports the achievement of goals
- Respond to customer inquiries ranging from routine to complex from members, clients, providers, and internal/external business partners; inquiries may range from telephone, in person, or via the internet/e-email
- Contingent on the Line of Business (LOB), requires in-depth knowledge in the following areas:
- Prescriptions, Plans, Products, Services, and Procedures Online purchasing & e-Commerce knowledge Internet knowledge Payment processing/payment collections Eligibility verification Order Status, Shipping Status, and Stock Availability
- Accurate completion of necessary documentation, letters, and forms processing
- Quality Assurance testing for company software Research and resolve issues/complaints and determine appropriate resolution(s)
Skills
- Good Internet Speed Required – Please share the internet speed screenshot
- MUST BE FLEXIBLE
- Monday - Sunday-Assigned based on business need
- Cannot take off the first two weeks during training
- Must have wired connection and meet the Upload and download speeds
- Must be comfortable taking phone calls
- Typically has the following skills or abilities:
- One to two years of customer service experience in handling moderate to complex customer inquiries in call center, insurance, manufacturing, software, telecommunications, retail, or eyewear industries
- Available to work any shift, including weekends, holidays, and/or overnight
- Demonstrated internet knowledge and understanding of basic internet browser settings
- Demonstrated ability to work with multiple software programs, simultaneously
- Working knowledge of MS Office package
- Effective verbal communication skills to prioritize multiple tasks and to be available for incoming calls and inquiries
Benefits
- ACA compliant medical coverage
- Dental insurance
- Vision insurance
- Sick time benefits as required per State regulations
Company Overview