Customer Service Representative I (4300)

About the role

The Customer Service Rep I handles calls from customers to resolve, educate, follow-up and respond to questions regarding ChoiceBuilder plan administration and procedures for groups, members, brokers and general agencies.

Responsibilities

• Understanding of company policies and procedures as they apply to ChoiceBuilder plans.
• Answers questions via telephone or email from groups regarding new hires, billing, rates, supplies, administrative procedures, etc.
• Educates, via telephone or email, employees/dependents regarding ID cards, administrative procedures, dependent coverage, address changes, etc.
• Follows-up on calls and emails from brokers regarding problems that their groups are experiencing with providers.
• Ability to interact with brokers, general agents and sales representatives on a daily basis and must be able to answer questions regarding ChoiceBuilder processes.
• Responds to calls from providers to confirm eligibility and benefits.
• Verifies enrollments and resolves issues with carriers.
• Expedites processing of members enrollment with carrier if urgent services are needed.
• Review and submit appeal requests from groups.
• Review /Audit group billing and explain to clients in clear and accurate manner.
• Document calls in call tracking system.
• Ability to