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The Health Plan (THP) · 14 hours ago

Customer Service Representative - Medicare

Wheeling, WV

Full-time

Onsite

New Grad, Entry Level

The Health Plan (THP) is seeking a Customer Service Representative responsible for answering phone calls and providing accurate responses to Members and Providers. The role involves timely completion of correspondence and reporting functions associated with the Customer Service Department.

Health CareInsuranceNon ProfitWellness

Responsibilities

Takes an average of 40-60 calls daily

Has established adequate proficiency in using the application necessary to perform the functions of a Customer Service Representative

Maintains monthly monitoring score of 90% accuracy or above on the 17 Points of Excellence

Demonstrates a complete understanding of departmental policies and procedures

Able to perform assigned tasks with minimal supervision

Meets requirements on annual performance evaluation

Consistently displays a positive attitude and acceptable attendance

Increasing improvement in performance and job knowledge

Documents calls according to departmental guidelines

Qualification

Medical TerminologyCPTICD-9/ICD-10 CodingFamiliar with medical claimsPCKeyboard skillsCommunication skillsOrganizational skillsCall center experienceCoordination of Benefits RulingEven temperamentProper usage of English

Required

High School Graduate: prefer 1-2 years college with interest or concentration in health field

Strong ability to relate with a variety of people in a non-judgmental manner

Strong organizational, verbal and written communication skills

Possess some knowledge of the health care system

Personal Computer (PC) and Keyboard skills

Proper usage of the English Language

Courteous manner/even temperament

Excellent communication skills

Preferred

Previous call center experience

Medical Terminology

CPT and ICD-9/ICD-10 Coding

Familiar with medical and hospital claims

Familiar with Prescription Coding (NDC)

Familiar with Coordination of Benefits Ruling

Company

The Health Plan (THP)

The Health Plan is a clinically-driven, technology-enhanced, and customer-focused health maintenance organization that manages and improves the health and well-being of its members.

Founded in 1979