HDSI: Customer Service Representative (Healthcare Account)
Job Overview:
The Customer Service Representative will act as a liaison, provide product/services information, coordinate with providers and facilities for members request, answer questions, and resolve any emerging problems that our customer accounts might face with accuracy and efficiency.
The Customer Service Representative will act as a liaison, provide product/services information, coordinate with providers and facilities for members request, answer questions, and resolve any emerging problems that our customer accounts might face with accuracy and efficiency.
This role will be hired under Health Delivery System, Inc. - a RelianceUnited company.
Duties and Responsibilities:
- Accept inbound calls from Flexicare members and accredited providers requesting for Letter of Authorizations. Address member concerns related to their health benefit program.
- Ensure that LOA request is issued within the members’ benefits based on their respective benefit matrixes, remaining limit and eligibility.
- Conduct outbound calls as needed to assist with claim information or identify missing information.
- Document all encounters in clear and concise logs.
- Consistently meet individual performance standards/metrics.
- Assist in other tasks that may be assigned.
Qualifications:
- A Bachelor’s Degree in medical field or any related degree
- At least 2 year(s) of solid working experience in the related field is required for this position.
- With experience working in TPA, HMO, insurance or insurance broker companies or BPO
- Ability to work on shifting schedules and extend beyond company operating hours when needed.
- Amenable to work onsite as advised
- Strong attention to detail.
- Strong communication (written and oral) and interpersonal skills.
- Familiar with health insurance / HMO policies and coverages, preferred.
- Organized, has strong attention to details, and can work with minimal supervision