Customer Service Associate

Buyer Service Affiliate – Distant

Distant, USA

Full time

job requisition id

R0006050

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Place Abstract:

Accountable for answering calls clearly and concisely, responding to questions, and offering steerage on transactions, inquiries, or complaints from each inner and exterior prospects. Paperwork and resolves inquiries by utilizing established finest practices and educates members about obtainable services, whereas adhering to compliance necessities and Facilities for Medicare and Medicaid Providers (CMS) requirements.

Job Description:

Major Tasks

• Responds to buyer calls precisely and professionally together with right grammar and a pleasant tone whereas additionally demonstrating a real delight to serve.
• Resolves customer support inquiries for 1-2 communities which might embody profit and eligibility data, billing and cost points, buyer materials requests, doctor assignments, authorization for remedy, and Clarification of Advantages (EOB).
• Handles escalated conditions and acts urgently when crucial
• Makes outbound calls to members, suppliers, pharmacies, and/or hospitals and so on. to resolve points as wanted.
• Investigates and responds to common inquiries whereas documenting within the system as applicable.
• Interacts with different departments together with Enrollment and Medical Administration to resolve points.
• Adheres to compliance necessities and CMS requirements.
• Supplies first name decision for all prospects.

{Qualifications}

• Excessive Faculty diploma, GED, or equal
• Familiarity with laptop, Home windows PC purposes, and the flexibility to study new and complicated laptop system purposes
• Working information of Microsoft Outlook, Phrase, Excel, and PowerPoint
• Stable verbal communication abilities together with the flexibility to talk to associates and prospects in any respect ranges
• Capability to be element oriented and arranged
• Sturdy investigative and problem-solving abilities
• Capability to learn, comprehend, and precisely observe directions in a consistently altering setting
• Sturdy dedication to Service Excellence and delivering a customer support expertise that ends in a 5 Star CMS score.
• Capability to work versatile hours together with weekends throughout a part of the yr in addition to extra time when wanted; Name Heart is open 7a-10p CT and schedules will range inside that timeframe based mostly on enterprise want

Most well-liked:

• 6+ months of associated expertise
• Prior well being care or insurance coverage expertise
• Bi-lingual

Working Circumstances

• Whereas performing the duties of this job, the worker works in regular workplace working circumstances.

Disclaimer

• The job description describes the overall nature and degree of labor being carried out by individuals assigned to this job and isn’t supposed to be an exhaustive listing of all duties, duties and abilities required. The bodily actions, calls for and dealing circumstances characterize these an worker encounters whereas performing the important capabilities of this job. Cheap lodging could also be made to allow people with disabilities to carry out the important job duties and duties.

#LI-REMOTE

Lumeris is an EEO/AA employer M/F/V/D.

The hiring vary for this place is:

$15.05-$18.01

Components that could be used to find out your precise pay fee embody your particular abilities, expertise, {qualifications}, location, and comparability to different staff already on this function. This function may additionally be eligible for incentive compensation. At Lumeris, we’re dedicated to offering a complete rewards package deal that helps your total well-being. Our advantages embody medical, imaginative and prescient, dental, well-being applications, 401(okay) with firm matching, life insurance coverage, paid time without work together with paid go away, and a lot extra. Be taught extra by visiting our Careers Web page.

Location:

Distant, USA

Time Sort:

Full time

Lumeris and its companions are dedicated to defending our high-risk members & prospects when conducting enterprise in-person. All personnel who work together with at-risk members or prospects are required to have accomplished, at a minimal, the preliminary collection of an authorised COVID-19 vaccine. If this function has been recognized as member-facing, proof of vaccination can be required as a situation of employment.