General Description: Assist clients and their employees with benefit or claim questions.
Responsibilities:
•Primary resource for clients and their employees with benefit or claim questions.
•Investigate and work with carrier contacts to solve claim problems.
•Respond to emails and voicemails within 24 business hours.
•Track and documents all calls and interactions in Call Center database.
•Assist clients with administrative questions regarding enrollment, eligibility, and special contract provisions.
•Assist with transition of care concerns due to a change in carrier.
•Provide help with coordination of benefits.
•Draft appeal letters and perform claim audits as needed.
•Report trends to carrier and/or the account manager.
•Maintain open call volume.
•Keep informed about industry information and new product information.
Knowledge, Skills and Abilities:
•Prior customer service experience preferred.
•Must hold Life and Disability insurance license or obtain within 12 months.
•Bilingual preferred.
•Comfortable with internet-based programs and Microsoft Office products.
•Strong attention to detail and ability to self-check work.
•Excellent time management skills, able to set priorities, and manage deadlines.
•Ability to work in a team environment.
•Resourceful, eager to learn new concepts, and further professional development.
•Ability to define problems and generate potential solutions.
•Strong verbal and written communication skills.
•Ability to remain calm in stressful situations.
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