Independent Health · 1 day ago
Servicing Representative
Buffalo, NY (14221)
Full-time
Hybrid
New Grad, Entry Level
$19/hr - $19/hr
0+ years expIndependent Health is a company focused on providing exceptional customer service in the healthcare sector. The Servicing Representative role involves advocating for customers, resolving inquiries, and ensuring compliance with regulations while maintaining accurate documentation of interactions.
Health CareInsuranceNon Profit
No H1B
Responsibilities
Act as a customer advocate by providing excellent customer service when answering phone calls, written correspondence and servicing walk-in members in a timely fashion. De-escalate customers as needed and resolve customer complaints
Ensure that our customers are obtaining accurate and up-to-date information on policies and procedures and communicate a successful resolution to inquiries
Ensure compliance with all CMS rules and regulations
Log all contacts into appropriate systems
Meet or exceed all department standards in the following categories as measured and recorded by the representative’s scorecard:
Quality goals - measure ability to consistently respond to customers with excellent customer service
Productivity goals - measure ability to be productive and use time effectively and efficiently to include average talk plus hold time, after call work (ACW), adherence, use of non-available states, tardiness and attendance
Accuracy goals - measure ability to respond to inquiries correctly and accurately
Maintain technical knowledge regarding Pharmacy Benefit Dimensions’ contracts and benefits and working knowledge of policies and procedures while maintaining updates daily. Attend required training sessions as needed
Provide accurate and up-to-date information to all customers by documenting all pertinent information into appropriate systems to meet regulatory agency standards (NCQA, State, CMS etc.), addressing first-level complaints and providing assistance on appeals as needed; receive and effectively resolve written inquiries from members regarding claims, benefits, eligibility, reimbursement and participating providers
Knowledge of all systems and training manuals and the ability to coordinate the use of these tools at the same time
Other duties as required by immediate supervisor which may include servicing walk-in members, correspondence support and making outbound phone calls
Qualification
Required
High school diploma or GED required
Six (6) months of experience working for a health insurance company, physician's office or pharmacy required
Ability to effectively communicate with internal and external customers
Excellent written and verbal communication skills, excellent customer service skills
Ability to listen with intent to understand
Proficient in verbally translating written communication
Typing 35-40 words per minute is required
Proficient in problem solving with the ability to prioritize accordingly
Ability to utilize multiple system tools simultaneously
Strong organizational and time management skills
Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring
Preferred
Associates degree preferred
Experience handling self-funded pharmacy calls preferred
Experience in a call center operations environment preferred
Experience handling high volume, inbound and outbound phone calls preferred
Benefits
Full range of benefits
Generous paid time off
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.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
unknown2025-11-18Acquired
Leadership Team
Michael W. Cropp, M.D., M.B.A.
President and CEO
Jim Dunlop Jr.
Executive Vice President and Chief Financial Officer
Recent News
vermontbiz.com
2025-11-19
2025-11-19
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