Apply on Employer Site

Evry Health · 1 day ago

REMOTE (CST or EST): Commercial Health Call Center Representative

United States

Full-time

Remote

Entry Level

2+ years exp

Evry Health is a company on a mission to bring humanity to health insurance, and they are seeking a Call Center Representative. The role involves providing accurate information on plan benefits, eligibility, and claims while delivering exceptional customer service to members and providers.

Health CareHealth InsuranceInsurancePersonal Health

Responsibilities

Research, reviews and responds to inquiries received from members and providers

Employs active listening skills, demonstrates patience and empathy, and can handle difficult calls tactfully, courteously, and professionally

Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure

Leverages company policies and procedures, benefits, claims, and eligibility to respond accurately to all inquiries

Handles member complaints and complaint appeals

Works with internal departments, vendors, business partners, providers, etc. to help coordinate problem solving in an effective and timely manner

Demonstrates basic understanding of company billing guidelines and can effectively interpret inquiries related to claims and claim payments

Accurately documents all calls

Recognizes trends and patterns in call types and engages leadership with suggested solutions

Accountable to meet and maintain established department production and quality standards, on both an individual and team basis

Assists members with navigating the member portal while encouraging them to becoming self-sufficient with our tools

Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations

Ability to effectively excel in a virtual work environment through active participation in team huddles, Supervisor 1:1s, Instant Messaging, or check-ins

Qualification

Customer service experienceMedical terminology knowledgeCRM proficiencyMicrosoft Office proficiencyFluency in SpanishCommunication skillsProblem-solving skillsAttention to detail