Health Insurance Customer Service Representative

Job Summary:

Key Responsibilities:

• Develop a solid understanding of plan provisions, benefit schedules, eligibility, claim systems, and the Reciprocity system.
• Respond promptly and accurately to inquiries via phone, email, and in-person, addressing questions about claims, eligibility, and benefits.
• Document all interactions in the Customer Service module.
• Perform clerical tasks such as entering enrollment forms and processing claims.
• Navigate and provide information regarding the company website.
• Monitor incoming calls and manage call queues.
• Handle messages from the nightline.
• Assist with special projects as directed by management.
• Perform additional duties as assigned.

Requirements:

• 1+ years of experience in a call center, preferably in medical billing or insurance.
• Bilingual candidates are strongly preferred.
• Bachelor’s degree or equivalent experience.
• Previous experience with a third-party administrator or insurance carrier is preferred but not required.
• Strong written and verbal communication skills.
• Proficiency in MS Office.
• Typing speed of at least 40 words per minute.
• Ability to manage complex issues while maintaining a positive attitude.
• Dependable attendance and punctuality.