Insurance

• Handle escalated and complex inquiries from Korean-speaking customers via phone, email, and chat.
• Assist with detailed questions related to health insurance plans, including policy terms, exclusions, coverage limits, and claims processes.
• Provide personalized support to resolve customer issues related to claim denials, policy disputes, and billing discrepancies.
• Investigate and resolve escalated claims issues by coordinating with the claims, underwriting, and billing departments.
• Offer detailed explanations of denied claims, guiding customers through the appeals process if necessary.
• Support customers in understanding and utilizing their policy benefits, deductibles, co-pays, and out-of-pocket expenses.
• Manage customer escalations professionally and efficiently, ensuring timely and accurate resolutions.
• Document all escalated cases in the CRM system, including detailed notes on the issue, resolution steps, and outcomes.
• Follow up with customers to ensure satisfaction and confirm that their issues have been fully resolved.
• Collaborate with internal teams (claims, billing, and product teams) to address more complex customer needs and policy adjustments.
• Provide feedback on recurring customer issues and offer suggestions for process improvements.
• Mentor CSRs by sharing knowledge, best practices, and assisting with challenging cases.
• Ensure that all communications and processes comply with industry regulations, such as HIPAA, and protect the confidentiality of customer information.
• Adhere to company policies and legal requirements regarding health insurance products and services.
• Stay up-to-date with changes in health insurance policies, products, and regulatory guidelines.

Health Insurance Support, Korean

Insurance Admin Specialist

Insurance Agent, EZLynx

Mortgage Insurance Administrator

Insurance Verification Specialist