Customer Service Representative - Fully Insured Employer Group
Company: Carle
Location: Urbana
Posted on: May 15, 2022
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Job Description:
Customer Service Representative - Fully Insured Employer Group +
Department: HA - Customer Solutions + Entity: Health Alliance + Job
Category: Clerical/Admin + Employment Type: Full - Time + Job ID:
24232 + Experience Required: 1 - 3 Years + Education Required: Not
Indicated + Shift: Day + Location: Champaign, IL + Usual Schedule:
M-F 8a-5p + On Call Requirements: N/A + Work Location: HA at The
Fields + Weekend Requirements: N/A + Holiday Requirements: N/A
Email a Friend Save Save Apply Now Position Summary: Responsible
for accurately and completely answering and documenting inquiries
from members, employers, employer groups and providers. Facilitates
communication between self, other departments, members, providers,
provider offices, employers, and brokers to ensure that needs of
members are met. Qualifications: EDUCATIONAL REQUIREMENTS None
specified CERTIFICATION & LICENSURE REQUIREMENTS Medical
Terminology within one (1) year of hire EXPERIENCE REQUIREMENTS
Three (3) General - Customer Service. Must be proficient in using a
computer keyboard, navigating multiple software applications,
managing a multi-line phone and completing documentation during the
course of a call. OTHER REQUIREMENTS Must be able to project a
professional, pleasant image, while interacting with a variety of
personalities and cultures. Must demonstrate tact and diplomacy in
interpersonal interactions, in addition to maintaining composure in
confrontational situations. Essential Functions:+ Meets standards
for documentation, answering and follow-up on all benefit,
eligibility, network, and claims inquiries from Health Alliance
members and providers generated by telephone, walk-in, or written
correspondence.+ Takes action to resolve customer service, claims,
or billing complaints by partnering with other departments if and
when necessary. Follows up to ensure that appropriate changes were
made to resolve the source of the problem. Refers unresolved
complaints to the Customer Service Complaint Resolution Specialist
or advises members/providers of the right to appeal.+ Educates
members and providers regarding a variety of insurance topics,
including, but not limited to Healthcare Reform, Exchanges,
coordination of benefits and Medicare coordination.+ Processes
requests for member materials including, but not limited to ID
Cards, federally required Summaries of Benefits and Coverage,
Policies, Schedules of Benefits, Provider Directories, Explanations
of Benefits, and Remittance Advices.+ Assists members in accessing
company websites.+ Consistently meets or exceeds department
specific performance and quality requirements.+ Basic communication
skills (Telephone Courtesy Guidelines P, scripting, and
scores/feedback from Quality Assurance Advisor and Customer Service
Lead).+ Basic computer skills (all applications used by Customer
Service).+ Basic problem solving skills.+ Follows and adheres to
accountability structure and required behavioral standards. We are
an Equal Opportunity Employer and do not discriminate against any
employee or applicant for employment because of race, color, sex,
age, national origin, religion, sexual orientation, gender
identity, status as a veteran, and basis of disability or any other
federal, state or local protected class. Carle Health participates
in E-Verify and may provide the Social Security Administration and,
if necessary, the Department of Homeland Security with information
from each new employee's Form I-9 to confirm work authorization. -
For more information: human.resources@carle.com.Effective September
20, 2021, the COVID 19 vaccine is required for all new Carle Health
team members. Requests for medical or religious exemption will be
permitted. With an approved exemption, healthcare workers must do
weekly testing and verify a negative COVID-19 test.
Keywords: Carle, Champaign , Customer Service Representative - Fully Insured Employer Group, Hospitality & Tourism , Urbana, Illinois
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