MUST BE ABLE TO COMMUTE TO LOCATIONS IN BROOKFILED OR MENASHA WISCONSIN We are looking for customer service professionals who have worked with Medicare and Medicare to join our growing team of Representatives The Member Experience Representative’s primary focus is to answer phone, or email inquiries from providers, members, customers or brokers regarding questions of coverage, claim status, benefit interpretation, billing and/or authorizations.
Description:
– This individual will be proficient in one line of business, either Medicare or Group/Marketplace, translating health care related terminology into effective written or verbal communication for the end user to comprehend.
– In addition to addressing the caller professionally and properly, the CSR will need to document details of the interaction within the database, including any additional action steps taken as follow up.
– Demonstrate commitment and behavior aligned with the philosophy, mission, values and vision
– Appropriately apply all organizational, regulatory, and credentialing principles, procedures, requirements, regulations, and policies
– Answer incoming phone calls from members, customers, providers or brokers efficiently regarding their inquiries on coverage, claim status, benefit interpretation, billing and/or authorizations.
Respond to inquiries within set timeframes to adhere to department metrics and contractual standards.
– During telephone call, probe and ask appropriate questions to identify specifics of what caller is inquiring about to ensure first call resolution.
– Follow-up with customers or other departments on any outstanding issues or concerns.
Escalate appropriate issues to Supervisor or appropriate individual.
Additional Details:
– Support our members by answering calls and proactively work to resolve our members questions and concerns.
– Strive for first call resolution, working to resolve member issues at the point of contact.
– Use dual monitors while leveraging computer-based resources to find answers to customers questions and help simplify next steps for members.
– You may reach out to internal departments or external resources to help resolve a member concern.
– We provide a continuous learning environment where you can learn and stay current with our plans, computer systems, and insurance trends.
– You will have the ultimate responsibility of protecting the personal health information of our members.
Skills: Customer service, Insurance, medicare, group insurance, Managed care, Health plan, Data entry, Health care, Claim, Microsoft office, Customer support, Benefits Top Skills Details: Customer service,Insurance,medicare,group insurance Additional Skills & Qualifications: Minimum Related Years of Experience (per minimum education) Required: Experience working in a customer service focused industry strongly desired.
Experience working in a call center preferred.
Knowledge of basic insurance concepts preferred.
Cultural: Strong oral and written communication skills with the ability to listen mindfully, identify gaps and ask appropriate questions Ability to organize one’s work and space to ensure successful completion of assigned tasks within the identified timeframe Ability to adapt to new circumstances, information and challenges in a fast paced environment Ability to work independently, as well as part of a team Strong conflict management skills, with the ability to resolve and deescalate situations solving customers or members concerns while maintaining service excellence standards.
Functional (job specific-at least three and no more than 10): Ability to work in a fast-paced environment with the ability to handle constant volume of phone inquiries or email messages.
Capacity to multi-task by using navigating multiple computer application and programs simultaneously.
Intermediate skills in Microsoft Office, including Outlook, Excel, and Word.
Comprehend and educate members on multiple lines of business for their inquiries About Aston Carter: Please Note: Scammers are posing as Aston Carter.
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At Aston Carter, we’re dedicated to expanding career opportunities for the skilled professionals who power our business.
Our success is driven by the talented, motivated people who join our team across a range of positions
– from recruiting, sales and delivery to corporate roles.
As part of our team, employees have the opportunity for long-term career success, where hard work is rewarded and the potential for growth is limitless.
Established in 1997, Aston Carter is a leading staffing and consulting firm, providing high-caliber talent and premium services to more than 7,000 companies across North America.
Spanning four continents and more than 200 offices, we extend our clients’ capabilities by seeking solvers and delivering solutions to address today’s workforce challenges.
For organizations looking for innovative solutions shaped by critical-thinking professionals, visit AstonCarter.com.
Aston Carter is a company within Allegis Group, a global leader in talent solutions.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email astoncarteraccommodationastoncarter.com (%20astoncarteraccommodationastoncarter.com) for other accommodation options.
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