MEDICAL CUSTOMER SERVICE REPRESENTATIVE

Company: Career Movers and Shapers
Location: Miami
Posted on: April 8, 2021

Job Description:

Job DescriptionOur client is looking for 15 Member Service Representatives to assist in their busy call center. You will assist in increasing member satisfaction by providing professional and accurate responses to incoming inquiries regarding network, plan benefits, eligibility, authorizations, plan guidelines and processes, as well as claims and pharmacy issues. This is a full time, temporary to possible permanent position.ESSENTIAL JOB FUNCTIONSProvide accurate information about eligibility, benefits, network details, authorization requirements, and claims processes to members or members representatives in a professional and timely manner.Make outbound calls to assigned members.Keep up and respond to voicemails left by members - within 1 business day.Focus on achieving departmental goals & objectives based on tenure.Use negotiating skills when dealing with emotional customers.Maintain an up to date and thorough knowledge of Company's product offerings and plan guidelines specific to job code.Properly document all calls/contacts as required by department standards in a clear and concise manner.Provide accurate research and resolution to member issues in accordance with established procedures.Escalate unresolved issues to the next level and/or appropriate area when necessary.Properly identify issues as possible grievances or appeals and follow those procedures accordingly.Act as a liaison between the member and internal/external entities when necessary.Maintain strict confidentiality of all sensitive information.QUALIFICATIONSHigh school diploma or equivalent.Bilingual - English and Spanish a plus.Call Center experience required.Minimum two (2) years experience in customer service in health care field.Knowledge of medical terminology, managed care industry and insurance billing guidelines preferred.Company DescriptionCareer Movers and Shapers is a proven recruiting/staffing firm. Career Movers and Shapers has a proven history of placing talented professionals in positions in South Florida. Associated topics: agente de servicio al cliente, answer, call center, call center representative, customer service representative, customer service specialist, intern, support, telephone, tsr

Keywords: Career Movers and Shapers, Miami , MEDICAL CUSTOMER SERVICE REPRESENTATIVE, Sales , Miami, Florida