The Alliance moves health care forward by controlling costs, improving quality, and engaging individuals in their health. As a not-for-profit, employer-owned cooperative, we exist to help our members manage their health care dollars while positively impacting their employees’ health. 

The Customer Service Representative serves as a primary resource to providers and member employers, responding to and resolving issues, questions, and complaints related to processing health insurance claims. Advocate for the consumer, educating employee members to be better health care consumers.

 Essential Duties and Responsibilities

• Provides customer service via the telephone, responding to questions and resolving issues related to claims, electronic claims filing, re-pricing and claims status.

• Makes calls to clarify claims or eligibility information.

• Documents and tracks call data and information.

• Proactively seeks to identify trends and refers to manager to determine next steps.

• Assists in the collection of eligibility information.

• Communicates caller issues with Customer Service team and other departments for resolution and process improvements.

• Assists with daily mail processing duties, including, preparing non-standard mail for scanning, responding to written inquiries, determining whether claims are secondary/Medicare prime, and routing misdirected and/or corrected claims to internal staff or outside entities.

• Assists Claims Processing unit

  Requirements

• The equivalent of a four-year high school education and at least two years customer service experience in an insurance-related field is required.

• Health insurance or health benefits experience is highly desired.

• Service driven with a dedication to providing outstanding customer service.

• Strong interpersonal and verbal communications and listening skills are essential. Must be able to clearly communicate with a variety of external parties, including members (customers) and providers.

• Ability to write routine reports and correspondence.

• Comfortable in a fast-paced, deadline-oriented environment.

• Ability to contribute effectively to a team environment.

• Well-organized with good attention to detail. 

• Demonstrated initiative with a focus on results.

• Proficiency with technology including Microsoft Office applications and software typically used in customer service.

The Organization 

As a not-for-profit cooperative, The Alliance is employer-owned and remains a trusted, objective partner for employers and their brokers who seek improved access to high-quality healthcare. 

We’re Madison-based, but we work with 300 employers across the Midwest and contract with over 34,000 doctors and other health care providers in the region. Our goal is to help employers better manage their healthcare costs while remaining transparent and emphasizing value – creating healthier, more engaged workforces. 

The Alliance is celebrating over 30 years as a mission-driven and member-focused collective with experienced leadership and strong organizational departments backed by top talent. By joining The Alliance, you’ll become part of a passionate, collaborative, and supportive organization: one that fosters meaningful connections and relationships with high levels of employee engagement and satisfaction. 

Our health plan is self-funded, which means we share the same interests and use the same tools that we offer our clients. We lead by example because when we take care of our employees, they take care of our clients (and their employees). 

We set our employees up for success, encouraging not only their professional advancement but also their personal growth. We offer a competitive compensation and benefits package, including health/dental/vision/life insurances, a generous Staff Incentive Bonus program, 401(k), annual Continuing Education and Wellness benefits, and a 4 ½ day workweek. 

The Alliance is committed to Diversity, Equity, and Inclusion and is an Equal Opportunity Employer. 

We Make it Easy

Founded in 1901, MRA is a nonprofit employer association that serves more than 4,000 employers, covering more than one million employees.

As one of the largest employer associations in the nation, MRA helps its member organizations thrive by offering the most comprehensive assortment of HR services, information, education, and resources to help build successful workplaces and a powerful workforce.

We partner with these companies working directly with their HR department and leadership to hire their talent. We are a direct line to the company, not an agency recruiter.