What are the responsibilities and job description for the Customer Service Representative position at The Health Plan of West Virginia Inc?
Available Shifts 9:00 AM-6 PM and 11:00 AM -8:00 PM
The Customer Service Representative is responsible for answering phone calls in a prompt and courteous manner to achieve contractual obligations. Responsible for answering Member's and Provider's questions with a quick and accurate response. They are also responsible for timely completion of all correspondence and reporting functions associated with the Customer Service Department.
Required:
- High School Graduate or equivalent.
- Strong ability to relate to all customers.
- Excellent communication skills.
- Some knowledge of health care and insurance.
- Computer and Keyboard skills.
- Proper usage of the English Language.
- Consistently displays a positive attitude.
Desired:
- 1-2 year post high school education with focus on healthcare.
- Previous call center experience.
- Knowledge of medical terminology.
- Knowledge of CPT and ICD-10 Coding.
- Familiar with medical and hospital claims.
Responsibilities:
- Takes an average of 40-60 incoming calls daily.
- Keep pended work at tolerable range (when applicable).
- Manage to work correspondence, faxes and e-mails in a timely manner.
- Maintains monthly monitoring score of 90% accuracy or above on the 17 Points of Excellence.
- Demonstrates a complete understanding of departmental policies and procedures.
- Able to perform assigned tasks with minimal supervision.
- Meets requirements on annual performance evaluation.
- Increasing improvement in performance and job knowledge.
- Documents calls according to departmental guidelines.