Note: The job is a remote job and is open to candidates in USA. The client is a leading healthcare insurance company seeking a Customer Support 1 - Claims representative. The role provides accurate, timely, and efficient customer support by responding to member, client, provider, and business-partner inquiries, processing claims-related work, completing documentation, and resolving issues.
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
- * MUST BE FLEXIBLE
- * Good Internet Speed Required – Please share the internet speed screenshot
- * Monday - Sunday-Assigned based on business need
- * Day(s) off during the week if shift includes Saturday and/or Sunday
- * Training Hours 8 am - 4:30 PST - 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
- * 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 for all employees
- Dental insurance for all employees
- Vision insurance for all employees
- Sick time benefits as required per State regulations
Company Overview