Customer Service Representative - LHB

Luminare Health hires a Customer Service Representative to respond to employee/member, provider, and client inquiries about benefits, eligibility, and claims. The role handles high-volume calls and other inquiries, navigates multiple systems, and accurately documents interactions and actions taken.

Responsibilities:

• Responsible for providing quality service by accurately and respectfully responding to telephonic, written and electronic inquiries from employees/members, providers and clients a high volume call center. Inquiries include a variety of topics such as benefits, eligibility, claim status, claim disposition and so on
• This role requires the ability to seamlessly navigate multiple system applications/screens, various resources and tools to accurately respond to inquiries while on the phone and to thoroughly/accurately document all inquiries and actions taken using applicable software applications while following Luminare Health guidelines

Requirements:

• High School diploma or GED equivalent
• Minimum 1 year previous customer service experience
• Ability to work in a fast-paced, high demand, structured service oriented environment
• Excellent verbal, written and interpersonal communication skills
• Ability to effectively deal with problems in varying situations and reach resolution in a timely manner
• Must possess strong reasoning and analytical skills and resolve issues for customers quickly and accurately while maneuvering between multiple systems/screens while on the phone
• Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form
• Flexible; open to continued process improvement
• Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word
• Prior experience in a fast-paced call center
• Self-Funded Insurance/Benefits and/or TPA experience
• Knowledge of medical procedure and diagnosis coding
• Knowledge of medical terminology
• Familiarity with Summary Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive tools
• Experience working in a performance measured environment with quality metrics