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Claims/Customer Service Rep

The Health Plan
  • Charleston, WV
    30+ days ago

    Job Description

    The CDS Rep is responsible for all aspects of processing payment requests for all Consumer Driven Product lines as well as answering customer telephone calls and inquiries in a prompt and professional manner.

    Required:

    • High School graduate or equivalent.
    • Motivated and works independently.
    • Detail oriented with good problem solving skills.
    • Ability to prioritize and meet deadlines.
    • Proficient in basic math skills.
    • Proficient in Microsoft Office products.
    • Adaptable to changes.

    Desired:

    • Two (2) years experience in a call center environment.
    • Familiar with insurance terminology.
    • Knowledge of FSAs, HRAs and/or HSAs.

    Requirements:

    • Claims and/or calls workload management.
    • Proficient use of necessary applications to perform various job functions.
    • Establish adequate proficiency in claims and customer service processing systems.
    • Meet requirements on annual performance evaluation.
    • Consistently displays a positive attitude and acceptable attendance.
    • Document calls according to departmental guidelines.
    • Strategic in call de-escalation.
    • Perform additional assigned tasks and complete them in a timely manner.

    Equal Opportunity Employer

    The Health Plan is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. The Health Plan strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. The Health Plan employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.

    8:00am - 5:00pm

    40

    Numbers & Facts

    LocationCharleston, WV
    IndustryInsurance
    Company Size500 to 999 employees

    About Company

    The Health Plan, established in 1979, is one of the largest locally managed care organizations in Ohio and West Virginia, serving over 350,000 covered lives. As a federally qualified and state certified 501 (c)(4) not-for-profit HMO, our goal is to provide high quality, comprehensive, and cost-effective health care. Our self-funded division, available in all 50 states, is the fastest growing product within in the organization offerings. The Health Plan is an established and financially secure organization and West Virginia's first and largest HMO.

    Skills

    • Call Centersunmatched
    • Customer Service Systemsunmatched
    • Customer Support/Serviceunmatched
    • Employment Lawunmatched
    • Establish Prioritiesunmatched
    • Health Planunmatched
    • High School Diplomaunmatched
    • Insuranceunmatched
    • Mathematicsunmatched
    • Microsoft Officeunmatched
    • Microsoft Product Familyunmatched
    • Payment Processingunmatched
    • Performance Analysisunmatched
    • Performance Reviewsunmatched
    • Telephone Skillsunmatched
    • Time Managementunmatched

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