Customer Service

Spotlight Talent Sourcing, LLC • Chattanooga, TN • 5d ago

Jobdescription

Responsibilities:

To obtain and maintain a working knowledge of the multiple benefit schedules, as well as a clear understanding of the eligibility system, claim system, and the Reciprocity system (ERTS)

Respond timely and accurately to phone calls, e-mails, walk in participants, and correspondence by answering questions; explaining claim payments and claim denials; quote self-payment amounts; verify eligibility and/or benefits; research eligibility or claim issues; update eligibility with outside vendors

Document all phone calls in the Customer Service module

Perform various clerical duties (i.e., enter enrollment forms; process working spouse forms, process special fund claims; process disability claims, etc.).

Navigate and provide accurate information regarding the website

Monitor incoming calls and calls waiting via the call management system

Pick up and handle messages from Nightline

Work on special projects as requested by Management

Other duties as assigned

Required experience:

1+ years of call center experience in a medical billing or medical insurance call center environment, or 1+ years of processing medical claims

Proficient in Microsoft Outlook and Word

Bachelors degree or equivalent experience required

Previous TPA or major insurance carrier experience strongly preferred, but not required

Excellent written and verbal communication skills.

Demonstrates ability to manage complex issues while maintaining a flexible, positive, and cooperative demeanor.

Responds promptly to operations leaders and stakeholders to facilitate informed decision-making.

Troubleshoot assigned issues, gather evidence and investigate all relevant information with participants, vendors, and internal departments to resolve the problem cooperatively and collaboratively.

Dependability - ensures timely arrival and consistent attendance to support the achievement of the teams goals.

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