JOB DESCRIPTION
Department: Claims
Position: Claims Customer Service Representative
Document Effective Date: 03/15/2022
Team: Claims
Review Date:
Responsibilities
JOB SUMMARY: Examine, perform, research and make the decisions necessary to properly adjudicate telephone and written inquiries
- Provide eligibility and claim status to policyholders or providers with a positive and professional approach
- Interpret contract benefits in accordance with specific claims processing guidelines
- Receive, organize and make daily use of information regarding benefits, contract coverage, and policy decisions
- Answer calls as required by company policy in a helpful, professional, timely manner
- Place outgoing calls as needed to provide or obtain information
- Document (written/on-line) all calls while in progress
- Transfer calls to employees in other departments as required to meet customer needs
- Actively participate in cross training and group training sessions to maximize team efficiency and maintain or exceed service standards
- Communicate openly with Supervisor, Team Lead and other team members to ensure accurate responses and avoid duplication of efforts
Required Skills:
- Intermediate knowledge of Microsoft Office systems to include Word and Excel
- Analytical skills
- Ability to prioritize and handle multiple tasks
- Ability to work in a fast paced/deadline driven environment.
- Ability to work independently or in a team oriented environment
- Ability to communicate clearly and concisely both verbally and in writing
Experience and Education:
High School Diploma or GED equivalent. Prefer candidates with an Associate Degree. Minimum of 1 year experience in a position requiring related skills. Will accept education in lieu of experience. Preferred background in healthcare industry, preferably insurance.
Job Type: Full-time
Pay: $17.00 - $21.00 per hour
Benefits:
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Referral program
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Application Question(s):
- Do you live in the Austin TX area and willing to commute to the office to work onsite?
- If you currently don't live in the Austin area, when do you plan to relocate?
- Are you interested in working in the office, hybrid, or a fully remote position?
Experience:
- Microsoft Office: 1 year (Preferred)
- Customer service: 1 year (Preferred)
Location:
- West Lake Hills, TX 78746 (Preferred)
Ability to Commute:
- West Lake Hills, TX 78746 (Required)
Ability to Relocate:
- West Lake Hills, TX 78746: Relocate before starting work (Required)
Work Location: Hybrid remote in West Lake Hills, TX 78746
