Address
Form of work
SalaryPRINCIPAL DUTIES AND RESPONSIBILITIES
· To obtain and maintain a working knowledge of the multiple benefit schedules, as well as a clear understanding of the eligibility system, claim system, and the Reciprocity system (ERTS)
· Respond timely and accurately to phone calls, e-mail, walk in participants, and correspondence by answering questions; explaining claim payments and claim denials; quote self-payment amounts; verify eligibility and/or benefits; research eligibility or claim issues; update eligibility with outside vendors
· Document all phone calls in the Customer Service module
· Perform various clerical duties (i.e., enter enrollment forms; process working spouse forms, process special fund claims; process disability claims, etc.).
· Navigate and provide accurate information regarding FMCP website
· Monitor incoming calls and calls waiting via call management system
· Pick up and handle messages from nightline
· Work on special projects as requested by Management
· Other duties as assigned
REQUIRED AND PREFERRED KNOWLEDGE, SKILLS, AND ABILITIES
· 1+ years of call center experience in a medical billing or medical insurance call center environment, or 1+ years of processing medical claims
· Proficient in Microsoft Outlook & Word
· Bachelor’s degree or equivalent experience required
· Previous TPA or major insurance carrier experience strongly preferred, but not required
· Excellent written & verbal communication skills
· Demonstrates ability to manage complex issues while maintaining a flexible, positive, and cooperative demeanor
· Responds in a timely manner to operations leaders and stakeholders to facilitate informed decision-making
· Troubleshoots assigned issues, gathers evidence, and investigates all relevant information with participants, vendors, and internal departments to resolve the problem in a cooperative and collaborative manner
· Dependability – ensures timely arrival and consistent attendance to support the achievement of the team’s goals.
Job Type: Full-time
Pay: From $20.00 per hour
Experience level:
- 1 year
Shift:
- Day shift
- Morning shift
Weekly day range:
- Monday to Friday
Work setting:
- Call center
- In-person
- Office
Work Location: In person
