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Independent Health · 1 day ago

Customer Service Representative

Buffalo, NY (14221)

Full-time

Hybrid

New Grad, Entry Level

$19/hr - $19/hr

Independent Health is seeking a full-time Customer Service Representative to join their team. The role involves providing excellent service to members, addressing inquiries, and utilizing various systems to resolve issues effectively.

Health CareInsuranceNon Profit

No H1B

Responsibilities

Provide excellent customer service when responding to customers and de-escalate customers as needed

Relay accurate and up-to-date information on policies and procedures and communicate a successful resolution to inquiries

Document all calls accurately and timely

Escalate issues to the appropriate resources as outlined in policy and procedure guides

Meet or exceed all quality, productivity, accuracy, and call identification goals as stated in the most current departmental policy

Maintain technical knowledge regarding Independent Health’s contracts and benefits and working knowledge of policies, procedures, and updates daily

Attend required training sessions as needed (including remote and onsite learning)

Provide accurate and up-to-date information to all customers by documenting all pertinent information into appropriate systems to meet regulatory agency standards

Utilize multiple systems and tools to obtain needed information related, but not limited to: Claims, Enrollment, Authorizations, Finance, Accounts Receivable, Reference Screens, Providers

Ability to determine claim status and whether claim is adjudicated properly. Must have knowledge and ability to make claim adjustments using established criteria

Qualification

Customer service experienceMicrosoft Office proficiencyCPT codes knowledgeICD-9 coding knowledgeMedical terminology knowledgeCommunication skillsCritical thinkingProblem solvingOrganizational skillsTime management skillsConfidentialityFlexibility

Required

High school diploma or GED required

Prior experience and success working in a customer service focused environment required

Excellent written and verbal communication skills. Ability to communicate with internal and external customers effectively and efficiently. Must be able to work collaboratively

Ability to think critically and listen with intent to understand

Ability to adapt behavior based on constructive feedback to improve job performance

Proficient in problem solving and ability to prioritize accordingly

Microsoft Office experience required with the ability to talk and type simultaneously. Must demonstrate proficiency in balancing keyboard accuracy with speed, the ability to correctly transmit data, and the ability to work efficiently while producing excellent customer service experiences

Strong organizational and time management skills

Ability to assume responsibility and maintain confidentiality. Strong sense of accountability is required

Flexibility to work additional hours as required by department. Flexibility in shift assignment required. Must have availability to work a shift between 8:00 a.m. and 8:00 p.m. during normal business hours. Weekend shifts and holidays may occasionally be required

Ability and willingness to meet with customers face to face at alternate locations when business needs require

Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable

Preferred

Previous experience working in a call center preferred

Knowledge of CPT codes, ICD-9 coding, and medical terminology preferred

Benefits

Full range of benefits

Generous paid time off

Scorecard incentive

Company

Independent Health

As one of Western New York's first HMOs, Independent Health covers approximately 355,000 people here and across the country with more than 100 plans, services and products.

Founded in 1980