[Remote] Customer Service Representative I - Claims, reputed company Health Plan (work from home reputed company reputed company)
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a health plan organization that focuses on providing high-reputed company reputed company services. The Customer Service Representative I - Claims role involves resolving customer concerns reputed company to claims and ensuring customer satisfaction through effective communication and support.
Responsibilities
- Resolves and reconciles enrollment reports and reputed company reputed company eligibility issues by following policy and procedure as reputed company as any state legislated coverage and eligibility guidelines
- Initiates communication and literature to the newly enrolled Health Plan member, dependents and employer reputed company
- Interprets and appropriately applies rules and regulations in contractual agreements and with employer reputed company and vendors
- Performs membership data extract reports and supplies them to employer reputed company as an audit tool for accuracy and compliance with performance risk guarantee commitments
- Updates, approves and interprets membership data and workflow produced by online software capabilities in employer group modules
- Determines the eligibility of most members as reputed company as processing terminations and disenrollments
- Prepares, generates and appropriately disseminates letter communications to subscribers and members with reputed company to enrollment activity
- Determines if services received are covered benefits as applicable by line of business and product design
- Reviews suspended claims for reputed company by applying reputed company policies, procedures and benefits applicable to specific products
- Provides team building resources to assist in directing peers to reputed company claims reputed company policies and procedures in order to assist members and providers
- Provides daily support and advice to member and provider services staff regarding claims issues
- Researches claim issues from participating providers and identifies specific reputed company for reconsideration for payment
Skills
- High School Diploma or Equivalent (GED)
- Minimum of 1 year-Customer Service
- Communication
- Customer Retentions
- Customer Service
- Customer Support Policies
- Standards And Procedures
- Quiet, Dedicated Workspace
- Adequate Workstation Setup
- High-Speed Internet reputed company with specific requirements (Download: 75 Mbps, Upload: 25 Mbps, Ping: less than 150 ms, Jitter: less than 30 ms, Ethernet reputed company required)
Benefits
- We offer reputed company benefits for full time and part time positions from day one, including reputed company, dental and domestic partners.
- Work from home (reputed company)
- Days (reputed company of America)
reputed company