POSITION SUMMARY
Answer inquiries, resolve issues, and handle customer (internal and external) concerns while maintaining a professional image through superb telephone etiquette and excellent customer service. Serve as a key member of a cross-functional team responsible for incoming and outgoing customer services for members, consultants, and others as related to Everence health products.
RESPONSIBILITIES AND DUTIES
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Answer inquiries regarding eligibility and confirmation of benefits for coverage of proposed services.
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Answer inquiries regarding the status of claims payment for all Everence health products.
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Research and assist in resolving all issues coming into the call center.
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Work with the cancelation of a policy and strive to retain membership.
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Provide coverage options for Medicare Supplement products including pricing.
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Maintain an understanding of Everence third-party administration products and services; Medicare and Medicare Supplement plans; Medicaid; corporate policies, and product-specific policies; procedures and business rules for the above-named products.
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Provide appropriate written correspondence to members and providers.
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Document all customer service contacts.
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Perform other duties and assignments as requested by the Health Member Services Manager.
QUALIFICATIONS
Experience:
High school graduate
Skills and Abilities:
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Ability to obtain and maintain a license in Health insurance
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Excellent verbal and written interpersonal and communication skills including a high level of listening skills
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Customer-oriented with the ability to adapt and respond to different types of customers with sensitivity
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Demonstrates initiative
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Ability to make quick and appropriate decisions despite interruptions
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Flexibility with changing work patterns and/or varying workloads
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Excel at problem-solving
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Attention to detail with the ability to multi-task and prioritize while managing time effectively
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Proficient computer skills and solid knowledge of Microsoft Office programs
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Ability to develop and maintain a strong sense of teamwork
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Medical and insurance background desirable
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Fluency in Spanish preferred
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Must be able to maintain call center hours (currently weekly 8 am to 5 pm)
SUPERVISORY RESPONSIBILITIES: None
SCHEDULE: Full-time