Customer Service Representative I

Job Description Summary

Under the direction of the Supervisor, Customer Service, this position is responsible for meeting Key Performance Indicators (KPIs) while responding to general customer inquiries regarding insurance benefits, provider contracts, reimbursement programs, eligibility, and claims from members, providers, and employers in a confidential, professional, and ethical manner. The incumbent will also research and analyze data to address standard operational challenges and issues within the Customer Service department.

Qualifications

• High School diploma or GED and/or one (1) to three (3) years of experience in customer service within a call center environment, preferred.
• Knowledge of Health Benefits and eligibility preferred.
• Good communication and telephone skills with a very clear and concise speaking voice.
• Proficient written communication skills with the ability to learn new software and navigate multiple systems at once.
• Moderate keyboarding skills including proficiency with database management.
• Proficient organizational and time management skills.
• Adaptive in constantly changing environment.
• Skilled in researching and resolving standard technical issues or client problems as they arise.
• Good judgement, negotiation abilities and capacity to work with minimal supervision.
• Capable to learn and understand company’s end-user software programs.
• Able to meet or exceed departmental service metrics.
• Fluent in English (oral and written) required.

Physical Demands/Work Environment

• The physical demands and work environment described here represent those that an employee must meet to successfully perform this job’s essential functions.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• While performing the duties of this job, the employee is regularly required to communicate with others.
• The employee frequently is required to move around the office.
• The employee is often required to use tools, objects, and controls.
• This noise level in the work environment is usually moderate.