Claims/Customer Service Rep

The Claims/Customer Service Representative is responsible for all aspects of processing payment requests for all Consumer Driven Product lines as well as answering customer telephone calls and inquiries in a prompt, professional manner.

Required:

1. High School diploma or equivalent.
2. Microsoft Office Skills (Word, Excel, Outlook).
3. Strong organizational, verbal, and written communications skills.
4. Courteous manner/even temperament.
5. Possess time management, organizational and multi-tasking skills.   

Desired:

1. Previous call center experience.
2. Previous experience with Consumer Driven Product processing.  Flexible Spending Accounts, Health Reimbursement Arrangements, Health Savings Account knowledge.
3. Ability to communicate effectively with clients.
4. Strong attention to detail.
5. Health insurance claims processing preferred but not required.     

Responsibilities:

1. Manages claims and/or calls at a level that is acceptable for their experience and training.
2. Establish adequate proficiency in using the application necessary to perform the functions of      Claims/Customer Service Representative.
3. Establish adequate proficiency in claims processing system.
4. Maintains monthly auditing scores of 90% accuracy or above.
5. Demonstrate a complete understanding of departmental policies and procedures.
6. Able to perform assigned tasks with minimal supervision.
7. Meets requirement on annual performance evaluation.
8. Consistently displays a positive attitude and acceptable attendance.
9. Increasing improvement in performance and job knowledge.
10. Document calls according to departmental guidelines.
11. Usually able to handle disgruntled or agitated members and resolve their issues.
12. Problem solving on more difficult claims or projects.
13. Perform additional assigned tasks and complete them in a timely manner.
14. May assist in training.