Customer Service Representative – ASO in MENASHA, Wisconsin

JOB REQUIREMENTS: Network Health’s success is rooted in its mission to
create healthy and strong Wisconsin communities. It drives the decisions
we make, including the people we choose to join our growing team.
Network Health is seeking a Customer Service Representative (ASO) who
will be responsible for promoting our “Service Excellence” model by
helping engage companies and their employees to navigate health care and
to provide support to better understand their benefit offerings. At
Network Health we strive to bring a better healthcare experience and
ensure that members only need to call once to get the help they need.
Our programs enhance convenience, improve employee health and help lower
costs so our members make the most of their health care benefits. Job
Responsibilities – Demonstrate commitment and behavior aligned with the
philosophy, mission, values and vision of Network Health – Appropriately
apply all organizational, regulatory, and credentialing principles,
procedures, requirements, regulations, and policies – Responds to and
resolves telephone, portal and email inquiries/issues from members,
providers, brokers, and employers. – Owns each inquiry/issue through to
resolution on behalf of the customer in real time or through
comprehensive and timely follow up. – Performs data entry at the time of
call, documenting all inquiries/issues for legal/statistical purposes. –
Meets the performance goals established for the position in the areas
of; Speed to answer, abandon calls, customer satisfaction and first call
resolution. – Channels callers and facilitates referrals to appropriate
Exceedent staff for escalated issues, precertification, subrogation,
claim detail, or appeals. – Produces follow-up correspondence to callers
in a timely manner. – Maintains knowledge of the SPDs and ASA documents
for all assigned employer groups. Maintains knowledge of the Operations
department policies and procedures. – Research complex issues across
multiple databases on behalf of the customer and work/partner with
Exceedent staff and vendor staff to resolve customer issues. – Performs
outbound calling as directed or needed to resolve issues and answer
questions. – Guides and educates customers about the benefits offered
under the plan and by our vendors to facilitate maximizing the value of
their health plan benefits to promote wellness. – Other duties as
assigned. ***** OTHER EXPERIENCE AND QUALIFICATIONS: A minimum of
three years of customer service experience is required. TPA environment,
health insurance or healthcare clinic experience is preferred. Telephone
experience in a call center setting or phone support role is also
preferred. ***** APPLICATION INSTRUCTIONS: Apply Online:
https://recruiting.ultipro.com/NET1004/JobBoard/4854471e-f2ab-4bed-a3cd-3f7a1072bfef/OpportunityDetail?opportunityId=b9d2093b-68ee-4df6-9bd7-50cc4cdbc8bf