Job Purpose
As a Third-Party Administrator for dozens of Healthcare Insurance companies located overseas, the Customer Service Representative is responsible to handle Inbound requests received via phone and email for “Expat”, “Destination” and “Travel” patients whose medical services will take place either in the United States or the rest of the world. Besides providing coverage details to medical Providers/insured Members, coordinating cashless appointments worldwide, providing bill status information to Providers, the CSR will work closely with the Case Management department on services that require an authorization which include identifying services that must be pre-certified and initiating the pre-authorization process. Last but not least, the CSR will be working with Account Management for any bill related matters that need to be escalated.
A customer service representative is responsible for assisting members, medical providers and clients over the telephone, via email, and/or through any other channel of communication by providing information about insurance plans such as but not limited to Expat, Travel and/or Destination insurance plans. He/she will be required to validate the member’s policy, provide policy benefits and confirm a member’s eligibility. He/she will also be required to respond to inquiries regarding the status of authorizations and bills as well as assist requesters in locating appropriate medical providers. A customer service representative is expected to promote excellence in all communications.
A level one customer service representative is defined as being fully trained in all products such as but not limited to Expat, Travel and/or Destination insurance products and services provided by the team as indicated below.
During off-hours (evening, weekends, nights and holidays), in addition to the above, he/she will be responsible for responding to and coordination of requests from corporate clients which can include sending eligibility and benefit details to medical providers, providing bill status, arranging medical appointments and other services.
KSA (Knowledge, Skills and Abilities/Attitudes)
Requirements:
- Bilingual (English & Spanish)
- Must be detail-oriented and organized
- Must possess critical thinking skills as well as the ability to manage time efficiently.
- Must be able to gather the information necessary to assist customers.
- Always be sharp and alert.
- Needs to communicate well with co-workers (verbal and written).
- Knowledge of phone manners, etiquette and protocols.
- Professional phone etiquette and written skills
- Ability to adapt to changes
- Able to understand, interpret and explain policies and procedures as well as knowledge of commonly used concepts, practices and procedures in the field.
- Ability to deal with irate customers and complaints while maintaining composure and control of the situation.
- Knowledge of Microsoft Office.
- Ability to learn from past experiences.
Tipo de puesto: Tiempo completo, Por tiempo indeterminado
Beneficios:
Idioma:
Lugar de trabajo: Empleo presencial
Job Types: Full-time, Contract, Permanent
Pay: $16,000.00 - $17,000.00 per month
Work Location: In person
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