[Remote] Customer Support Representative - Missouri Work-from-Home
Note: The job is a remote job and is open to candidates in USA. PacificSource Health Plans is seeking a Customer Support Representative to help their members access quality, affordable care. The role involves providing excellent customer service primarily by telephone, assisting customers with coverage and claims-related questions, and conducting research for prompt resolution of disputed claims.
Responsibilities
- Work efficiently in a high volume call center while maintaining a professional, positive, and caring demeanor
- Assist callers with coverage related questions/concerns; accurately interpret policy provisions for assigned products
- Analyze customer’s inquiries and determine correct steps for resolution, interpret benefit information, and claims processing accuracy. Keep resource information up to date and well organized
- Work efficiently in multiple systems simultaneously while effectively utilizing critical thinking and problem solving skills
- Document calls in a clear and consistent manner in computer system
- Conduct appropriate research, take ownership and follow through for prompt resolution of disputed claims
- Relay information to appropriate departments and personnel using established communication channels and procedures
- Make outbound calls to members as necessary dependent upon current outreach campaign
- Meet department and company performance and attendance expectations
- Be aligned with PacificSource company values
- Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information
- Perform other duties as assigned
Skills
- One-year medical insurance, other healthcare related field, call center or customer service experience required
- High School Diploma or equivalent required
- Basic understanding of insurance and medical terminology, coding and standard medical billing practices required
- Proficient computer skills, typing, and 10-key required
- Strong written and verbal communication skills required
- CPT/ICD-10 coding preferred
- Basic understanding of insurance and medical terminology, coding and standard medical billing practices preferred
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