Call Center Service Associate (FEP)
Apply Here Job Description :
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware
Job Summary:
Provide excellent service to customers through the resolution of basic customer inquiries received by phone or though written correspondence.
Responsibilities:
- 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.) in order 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.
This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job. Education/Experience:
- High School Diploma/GED required
- Some experience in a call center or customer service role within the health insurance industry preferred.
Knowledge:
- Medical terminology and medical billing coding preferred
Skills and Abilities:
- Excellent Customer Service skills including the 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
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The employer may require an employee to pass a test(s) as part of determining whether the applicant meets the minimum qualifications for the job.
- Comprehensive health benefits (Medical/Dental/Vision)
- Retirement Plans
- Generous PTO
- Incentive Plans
- Wellness Programs
- Paid Volunteer Time Off
- Tuition Reimbursement
