Note: The job is a remote job and is open to candidates in USA. Montage Health is seeking a Customer Service Representative I to assist health plan members and healthcare providers with inquiries related to eligibility, claims status, and benefits. The role is essential for supporting members, requiring a compassionate and solution-oriented individual to handle various customer interactions efficiently.
Responsibilities
- Interacts with customers (client, member and provide) via telephone, email, or in person to provide support and information specific to eligibility, benefits, claims, prior authorization requirements and appeals
- Document all communication in the applicable system of record
- Provide proactive education to customers, as it relates to their specific inquiry
- Provide accurate and timely responses to all customer inquiries
- Successfully bring all issues to closure within appropriate timeframe
- Provide support and coverage to inter-departmental staff as needed
- Coordinate customer appeals and grievances with appropriate staff
- Perform other activities and functions as assigned
Skills
- Excellent verbal and written communication skills, including active listening
- Minimum three years' experience in customer service, call center, or similar
- Service-oriented; Ability to resolve customer complaints and issues while maintaining a professional and calm demeanor
- Ability to operate spreadsheet, word processing programs and computer equipment required to fulfill position responsibilities
- Exceptional diplomacy skills to effectively resolve issues under sometimes tense and stressful circumstances
- Excellent phone manner
- Ability to use sound judgement, identify next steps to be taken, and develop appropriate solutions
- Associates degree, or applicable professional experience, required
- Minimum 1 to 3 years experience in a customer service, hospitality, or call center
- Bilingual Spanish/English desired
Benefits
- Competitive benefit package
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