Call Center Professionals - Hybrid Opportunity in ...

We are offering a $1000 sign-on bonus for the training class beginning November, 2023 Job Requirement: Proactively receive and respond clearly to telephone calls and correspondence from members regarding billing, benefits, coverage, payment, coding, and health services policies and procedures. Demonstrate a customer service attitude on the initial call with a commitment to resolve customer issues including claims, benefit and enrollment inquiries through health plan navigation and collaboration with other internal groups. Function as a scheduling agent, working in collaboration with the member, to ensure appointments are scheduled, as necessary. Maintain telephone log documenting number, content and type of calls received. Explain medical pre-authorization requirements and disposition of pre-authorization requests, as necessary. Research and analyze recurring billing and eligibility problems/complaints to determine root causes and trends. Provides instruction to members for submitting out-of-plan medical claims. Investigate requests for claims adjustments by members and collaborates with internal teams to ensure adjustments are made. Inform and educate members on how to utilize self service capabilities and functionality with the portals and mobile application. Gather and proactively provide feedback to stakeholders based on member feedback to further improve customer experience. Essential Job Information: 4 weeks of in classroom training onsite; with the possibility of working remotely once performance standards and probationary periods are met Primarily sedentary Required Qualifications: • High School degree or equivalent • Up to 2 years of customer service experience • Microsoft office experience; with keyboarding and basic computer proficiency • Strong customer service skills • Excellent written and communication skills • Strong problem-solving and multi-tasking skills • Ability to collaborate and work effectively within a team environment Preferred Qualifications: • Associate or higher degree • Up to 2 years of call center experience in healthcare industry • Bi-lingual Spanish

Created: 2025-11-26