What are the responsibilities and job description for the Claims/Customer Service Representative position at The Health Plan (THP)?
The CDS Rep is responsible for all aspects of processing payment requests for all Consumer Driven Product lines as well as answering customer telephone calls and inquiries in a prompt and professional manner.
Required
The Health Plan is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. The Health Plan strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. The Health Plan employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.
8:00am-5:00pm
40
Required
- High School graduate or equivalent.
- Motivated and works independently.
- Detail oriented with good problem solving skills.
- Ability to prioritize and meet deadlines.
- Proficient in basic math skills.
- Proficient in Microsoft Office products.
- Adaptable to changes.
- Two (2) years experience in a call center environment.
- Familiar with insurance terminology.
- Knowledge of FSAs, HRAs and/or HSAs.
- Claims and/or calls workload management.
- Proficient use of necessary applications to perform various job functions.
- Establish adequate proficiency in claims and customer service processing systems.
- Meet requirements on annual performance evaluation.
- Consistently displays a positive attitude and acceptable attendance.
- Document calls according to departmental guidelines.
- Strategic in call de-escalation.
- Perform additional assigned tasks and complete them in a timely manner.
The Health Plan is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. The Health Plan strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. The Health Plan employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.
8:00am-5:00pm
40