Portal Services Representative I

Important things YOU should know:

• Schedule: Monday - Friday, 8:00am - 4:30pm CST
• Please know hours of operation are 8:00am - 6:00pm CST so shift could flex based on business need.
• Fully Remote

What will YOU be doing for us?

Increase member, provider and client use of our web based solutions for claims submission, payments, and authorizations.

What will YOU be working on?

• Provide education to callers on the benefits of utilizing the member and provider insurance portals.
• Service dental, medical, vision and physical therapy members and providers using the member and provider portals offered by SKYGEN USA.
• Provide feedback to multiple internal departments regarding issues found on the member and provider portals.
• Ensure all calls are answered according to company and client guidelines.
• Accurately document call information and resolution in internal systems while engaging with members and providers.
• Properly identify potential issues that are not easily resolved and escalate appropriately to Manager.
• Perform outbound calling projects as directed.

Additional Responsibilities:

• Utilize multiple modules in the Enterprise System to research portal questions.
• Work with internal departments to produce, maintain, and deliver portal training references and materials.
• Work with call center to resolve outstanding follow ups generated from incoming calls.
• Using automated systems, maintain updated data on portals by verifying accuracy and handling any exceptions or issues.
• Act as a liaison between portal users and clients to resolve escalated issues.
• Provide recommendations on system enhancements and process improvements to management.
• Assist department with administrative tasks and additional duties as needed.

What qualifications do YOU need to have to be GOOD candidate?

• Required Level of Education, Licenses, and/or Certificates
  • High school diploma/GED required
• Required Level of Experience
  • 1 year of customer service experience (Call Center, Provider Relations).
• Required Knowledge, Skills, and Abilities
  • Intermediate knowledge of Microsoft programs (Word, Excel, and email)
  • Excellent attention to detail
  • Excellent oral and written communication skills
  • Ability to successfully meet timelines for project plans
  • Strong navigation skills and the ability to multi-task

What qualifications do YOU need to have to be a GREAT candidate?

• Preferred Level of Education, License, and/or Certificates
  • Associates degree/2 year degree in related field
• Preferred Level of Experience
  • 1-3 years of customer service experience (Call Center, Provider Relations).
• Preferred Knowledge, Skills, and Abilities
  • Knowledge of contract terminology
  • Understanding of reimbursement methods
  • Knowledge of dental, medical, physical therapy and vision products and terminology