Customer Service Representative - Healthcare

The Customer Service Representative will take inbound and make outbound calls regarding specified requests, common questions and pursue one call resolution for health share members and providers. The Customer Service Representative works with all departments to ensure that members and providers receive accurate health share information as determined by the Membership Guidelines.

Essential Duties:

• Answer incoming calls from members and providers and follow-up with outbound calls as necessary.
• Resolve general member and provider issues by phone or email.
• Identify and escalate issues as necessary.
• Recognize and document trends or problems that may arise in operations and alert management when needed.
• Provide accurate health sharing information and service to members and providers.
• Obtain and review medical records as necessary.
• Ensure member information and eligibility is accurate and up to date.
• Explain detailed information regarding eligibility to both members and providers.
• Is coachable and willing to learn.
• Capable of providing the greatest customer service experience possible.

Skills Required:

• Critical thinking and problem-solving skills
• Self-motivated, goal-oriented individual
• Excellent written, verbal, and interpersonal communication skills
• Work independently and in a team environment