Commercial Health Call Center Representative
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Job Description
Call Center Representative providing health plan support and exceptional customer service for Evry Health. Responsible for inquiries related to benefits, eligibility, and claims.
Responsibilities:
- Provide accurate and thorough information on commercial health plan benefits, eligibility, and claims.
- Handle inbound and outbound calls as well as respond to email inquiries from customers.
- Responsible for developing processes, call scripts, metrics, and desk top procedures.
- Deliver an exceptional customer service experience to Evry members and providers.
- Report to the Director of Operations and partner with senior leadership daily.
Requirements:
- Minimum of 2 years of customer service experience supporting a commercial health plan (not just Medicare, Medicaid, or Pharmacy)
- Experience collaborating and supporting business and operational units such as Claims, Medical Management and Appeals and Grievance.
- Knowledge of medical and insurance industry terminology including CPT/ICD-10, HCPCS and Revenue Codes.
- Excellent communication skills, both verbally and in writing, and can articulate and communicate complex topics to a broad audience.
- Comfort working in a fast-paced, deadline-oriented work environment.
- Strong attention to detail and problem-solving skills with a high level of accuracy.
- Proficiency in Microsoft Office applications Word, Excel, Outlook OneNote, etc.
- Prior experience using a CRM, preferably SalesForce.
- Bonus: fluency in Spanish.
Benefits:
- Competitive salary
- Comprehensive health, dental, and vision insurance as well as life and disability
- Retirement savings plan with company match
- Generous time off/vacation
- Professional development opportunities
- Flexible and remote work environment
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