Customer Service Representative (04) - Healthcare Experience Required

Customer Service Representative

Job Summary

The Customer Service Representative will take inbound and make outbound calls regarding specific requests, common questions and pursue one call resolution for health share providers. The CSR will work with a number of other departments to ensure that providers and service partners receive accurate health share information as determined by the Membership Guidelines and Provider policies.

Responsibilities

• Answer incoming calls from providers and follow-up with outbound calls as necessary.
• Resolve general provider issues by phone or email.
• Identify and escalate issues as necessary.
• Recognize and document trends or problems that may arise in operations and alert management when needed.
• Provide accurate health sharing information and service to providers.
• Obtain and review medical records as necessary.
• Ensure member information and eligibility is accurate and up to date.
• Explain detailed information regarding the eligibility and enrollment of members to providers.
• Is coachable and willing to learn.
• Capable of providing the greatest customer service experience possible.