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Healthcare Customer Service Specialist

Salary undisclosed

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Pay Rate: $24/hr on W2

Must-Have:

• Must have a Laptop/computer with internet to work from home.

• Comfortable providing a Photo ID Copy

Terms of Employment

• Contract-to-Hire, 6 months

• This is a 100% remote opportunity. Candidates must reside in Maryland, Washington, DC, Virginia, West Virginia, Pennsylvania, Delaware, New Jersey, New York, North Carolina, Florida, or Texas.

Overview

Our client is seeking three (3) Customer Service Advocates to be responsible for answering member, provider & broker inquiries pertaining to product information, benefits, claims resolution, eligibility and billing questions in a call center environment. As a Customer Service Advocate, you will proactively provide information and education to members, providers & brokers, as appropriate, about a variety of health, financial, and self-service programs. You will provide basic technical assistance and troubleshooting guidance for digital and electronic applications.

Responsibilities

• Provides first- level problem resolution to member, provider & broker inquiries via telephone by gathering and researching information; examine claim submissions verifying claim and system accuracy as well as liability, validate customer understanding of information and resolve issues based on applicable policies and procedures.

• Uses knowledge of products and the contractual provisions that govern administration to provide customer service and education, to interpret contractual language to the customer for the purpose of providing benefit utilization and limitations, to determine the need for managed care initiatives, and to administer all types of services to customers within the business segment through telephonic inquiries, written and/or electronic inquiries and claims adjustments, if applicable.

• Appropriately documents all client interactions according to established departmental procedures.

• Delivers accurate information to customers in accordance with performance goals and objectives.

• Maintains customer records by updating account information by effectively utilizing the business areas enrollment/inquiry tracking system & processes.

• Participates in ongoing education related to new services, industry topics, and skills.

Required Skills & Experience

• High School Diploma or GED and 3 years of customer service experience.

• Demonstrated skills as an empathetic and compassionate communicator.

• Ability to quickly gain customer trust and confidence.

• Demonstrated PC navigation and data entry skills.

• Strong interpersonal communication skills.

• Good oral and written communication skills.