Provide excellent service to customers through the resolution of basic customer inquiries received by phone or through written correspondence.
Receive customer inquiries via phone, fax, mail, e-mail, etc.
If necessary, probe for additional helpful information (i.e. member ID, claim number, name, etc.) to effectively handle inquiry.
Review computer systems and/or other reference materials to complete verification process.
Initiate investigation process based on the nature of the inquiry (claim, member information, benefits, enrollment, appeals, etc.).
Utilize available resources to quickly and efficiently resolve or redirect inquiries in accordance with prescribed departmental process.
Accurately document customer inquiries and actions taken in accordance with departmental quality guidelines to ensure appropriate follow up.
Follow up on unresolved issues in a timely manner, escalating call trends to management.
Deliver an excellent customer service experience while meeting quality and production standards.
Perform other relevant tasks as assigned by management.

High School Diploma/GED required
Some experience in a call center or customer service role within the health insurance industry preferred.
Knowledge of medical terminology and medical billing coding preferred
Excellent Customer Service skills
Ability to manage and diffuse irate calls
Ability to work in a high pressure, fast pace environment
Keyboarding proficiency
PC proficiency
Strong verbal and written communication
Interpersonal skills (i.e. active listening)
Investigative and analytical skills
Ability to multitask
Time management skills
Flexibility and adaptability
Ability to work effectively within a team environment

Call Center Associate

Key skills