Customer Service Representative
About Us:
Helpware is a technology-driven company with offices in the USA, Ukraine, Mexico, and the Philippines which provides Customer Experience & Operational Support for modern companies. Our team of professionals is driven by the purpose of providing best in class value-adding services to our partners by leveraging our empowered teams, innovative solutions, and technologies.
Position Overview:
The Customer Service Representative is responsible for handling inbound calls from health plan members with questions about their benefits. including medical, dental, and vision. You will identify and resolve employee questions and concerns by researching plan documents and your communications with employees will be on the phone and through written communication. Our agents must possess a professional demeanor, excellent customer service skills and a desire to help our health plan members navigate their health plan benefits to get the care they need.
Primary Responsibilities:
- Answer phone inquiries regarding health care coverage, eligibility for benefits, account status, claims, billing, address changes, and benefits verification.
- Utilize reference material and fee schedules to obtain accurate information.
- Contacting sources within or outside the organization to obtain information.
- Identify and determine action to be taken to resolve a variety of problems.
- Prepare or initiate a variety of correspondence and documents to respond to inquiries or to adjust records.
- Prepare routine reports and document all phone inquiries in patient notes.
- Perform other related duties as assigned.
- Demonstrate diplomacy and tact while interacting with all levels within and outside of the organization
- Maintain composure under pressure situations
Qualifications:
- Must be 18 years or older
- Authorization to work in the United States
- A minimum of one year experience in a call center
- Knowledge of medical terminology, CPT, HCPCS and ICD-10 codes preferred
- Bilingual a plus
- Ability to safely and successfully perform the essential job functions with or without a reasonable accommodation, including meeting qualitative and/or quantitative productivity standards.
- Ability to maintain regular, punctual attendance.
- Ability to sit for 6-8 hours.
- Constant use of computer keyboard and mouse; repetitive use of both hands.
- Occasional to frequent twisting of neck; occasional bending of neck and at waist.