• Evaluates, and resolves inquiries involving a variety of claim, benefit, membership, and/or billing inquiries. 
• Conducts internal and external research to determine and request the data needed to handle inquiries from internal and external business partners.
• Provides accurate and timely servicing responses via telephone, and/or written correspondence to our internal and external customers.
• Follows department/corporate reporting policies and procedures requirements.
• Organizes work to meet productivity and quality standards.
• Reroutes misdirected inquiries.
• Interacts with others inside and outside the organization to resolve inquiry/claim-related problems.
• Resolves customer inquiries through clear and simple explanations of the applicable policy and/or procedure.
• May assist less experienced Customer Service Representatives and handle unusual or urgent inquiries, including irate calls.
• Perform other related duties as assigned.

• A high school graduate or GED equivalent is required.
• One year of related work experience in areas such as public/customer service, sales representative claims processing, membership/billing/enrollment; and one (1) year of customer service experience in positions such as teaching, social service work, bank teller, medical assistant/office assistant, retail.
• Demonstrated knowledge of policies, practices, and procedures related to membership, billing, contract coverage or changes, rating and eligibility requirements, and/or claims processing.
• Demonstrated ability to resolve inquiries related to benefits, claims to process, and/or membership/billing, with little or no assistance.
• Demonstrated command of all oral, written, and interpersonal skills necessary for communications with subscribers, beneficiaries, accounts, or providers, in a clear, concise, and tactful manner. Employees shall meet a twenty-four (24) month tenure requirement, excluding training.
• Other related skills and/or abilities may be required to perform this job.
• All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status, or status as an individual with a disability.
• Must be fully vaccinated before starting position. 

• This is a Direct Placement position.
• Career growth opportunities and skill development.
• They have a tuition assistance program – a reimbursement program.
• Awesome training ground for limited experience: Minimal experience required (Specifically they ask for about one 1-year experience in any customer-facing role.
• Super affordable healthcare, including medical, dental, and vision: A single member would potentially pay less than $4 per month and a family (regardless of size) would pay less than $20 per month for health benefits.
• Pension, 401K, and PTO.

Job Summary