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Customer Care Representative I – Telecommuter
Sharp HealthCareCustomer Care Representative responsible for member communication and problem-solving for health plan inquiries. Requires 6 months of customer service experience and a high school diploma.
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
customer serviceproblem-solvingcall documentationprescription drug eligibility verificationclaims processingenrollment verificationbenefits verificationMedAccess systemSalesforce
Soft Skills
communicationjudgmentresearchresolutioninterpersonal skills
Tools & Technologies
IDX Customer Service ModuleMedAccess systemSalesforce
Certifications & Qualifications
H.S. Diploma or EquivalentAssociate's Degree in Business administrationAssociate's Degree in health care administrationMedical office certification
Industry Keywords
customer call centercommercial member inquirieshealth care administrationmedical office experience
About the role
Key responsibilities & impact- Responsible for direct and timely communication between the Plan and Plan members, potential members, providers, employer groups, brokers, internal departments and external agencies.
- Maintains high level of knowledge regarding Plan products, premiums, benefits and procedures.
- Uses knowledge and judgment to select appropriate resources for assisting callers.
- Provides information on all aspects of Plan products, premiums, benefits, policies and procedures.
- Responsible for accurate problem-solving. Researches and resolves concerns.
- Documents all calls in the IDX Customer Service Module immediately.
- Verifies prescription drug eligibility, benefits, claims, and authorizations in PBM's MedAccess system.
- Adds and updates member information in the MedAccess system.
- Verifies enrollment, benefits premiums and other individual and group information in Salesforce.
Requirements
What you’ll need- H.S. Diploma or Equivalent
- Less Than 1 Year Minimum of six (6) months experience as a Customer Call Center Representative.
- Associate's Degree in Business administration or health care administration preferred.
- 2 Years Customer service or medical office experience preferred.
- 1 Year Experience working full time as SHP Customer Care Temporary CCR I.
- Medical office certification, preferred.
- Ability to understand and resolve common Commercial member inquiries/complaints by phone.
Benefits
Comp & perks- Health insurance
- Paid time off
- Professional development opportunities