Call Center Representative

Job description

·  Job Description:

The Insurance/Healthcare Job family contains positions associated with providing consultancy utilizing knowledge and expertise on insurance andhealthcare.  Develops and implements general insurance and health polices in accordance with state and federal laws.   Provide eligibility information to the members and callers gatheringinformation.  Provides expertise to investigate and adjudicate claim characteristics that do not match policy provisions.  Responds to providersproblems/issues. 

Responsibilities:

·  Participates productively as a member of the team.
·  Completes tasks beyond general support level.
·  Accepts instructions and directions from leadership.  Ability to manage tasks and assignments without detailed directions.
·  Identifies, prioritizes and resolves some issues independently and escalates more complex questions or issues appropriately.
·  Complies with contract requirements, business unit rules and related and legal regulations

Education and Experience:

·  High School diploma or equivalent; may hold 2 year post-high school degree; may hold bachelor’s degree.
·  Typically, 1-2 years of working experience in related field.

Knowledge and Skills:

·  Prior Office or clerical experience.
·  Ability to follow written policies and procedure.
·  Ability to access and retrieve information using a PC and basic understanding of Microsoft Office products.
·  Ability to follow procedural guidelines.
·  Ability to work on assignment with limited instructions from leadership.
·  Good written and verbal communication skills, including professional telephone skills.