Description
Insurance Service Center Rep
DESCRIPTION:
The overall objective of this position is to perform the account maintenance, billing, reconciliation, reporting and/or customer service related activities.
Duties could include one or more of the following: performing database maintenance and research tasks to support the contracts administration, cash control operations and assignment of medical record numbers, to generate and distribute contracts and member I.D. cards, to provide facilities support and to enter documents into the workflow imaging system.
Identifying, researching and reconciling billing payments amounts to ensure accurate eligibility determination, payment, revenue and membership records
Setting up and maintaining member data including but not limited to processing enrollments, corrections, retroactivity adjustments and terminations
Supporting eligibility inquiries
Ensuring bills are correct and mailed timely
Interacting with purchaser benefit administrators to answer questions and explain Health Plan policy and contractual provisions related to membership and billing. Resolving related problems
Assisting Health Plan purchaser contacts and sales and service representatives in the sales process and the analysis and resolution of problems related to membership accounting
Resolving payment discrepancies and delinquencies
Identifying, coding, batching, scanning and indexing documents for imaging
Providing office services support including but not limited to picking up, sorting and delivering mail, filing and retrieving documents, ordering and distributing office supplies, performing miscellaneous facilities maintenance tasks and providing photocopying and copier maintenance
Working with internal and external customers and vendors to resolve any issues related to support services activities
Collecting and monitoring productivity and customer service quality measures
Participating team-based projects and contributing to customer service and operations improvements initiatives
Assisting with training as required
Facilitating communications across all lines of business and with other departments
Participating in purchasers performance evaluations and performance target setting activities
Perform other duties as they are assigned
REQUIREMENTS:
Minimum of 2 years experience in accounting, finance or related field preferred
Proficiency in math, data entry, typing, spelling and grammar, for which tests are required
Demonstrated ability to work in a team-based environment
Successful customer service track record
Ability to diagnose, analyze and solve a variety of quantitative and qualitative problems
Ability to communicate clearly and professionally
Computer experience preferably in a PC windows based environment
Willing to learn new tasks and adapt to new business requirements
Excellent conflict resolution and decision making capabilities
Ability to work productively at multiple tasks
Ability to adapt to change and be flexible in shifting priorities
Computer Literate
Analytical Abilities
Works well in a team environment
Detailed
Contract Interpretation
Research
Conflict Resolution
Decision making with minimum facts
Adaption to Change
Phone Skills
Professional email etiquette