Call Center Representative Position Available In Dauphin, Pennsylvania

Description Responsibilities include answering incoming calls related to eligibility, benefits, claims, and authorization of services from members or providers.

• Respond accurately to inbound calls and process inquiries from providers and members.
• Resolve customer service or billing issues under general supervision, using sound judgment.
• Contact customers to address complex inquiries or inform them of claim investigation outcomes.
• Refer unresolved grievances, appeals, and claim resolutions to appropriate departments.
• Maintain records of customer interactions and transactions.
• Listen actively and probe callers to understand the purpose of their calls.
• Research and communicate information regarding member eligibility and claim status.
• Educate providers on claim submission processes and treatment plan requirements.
• Perform follow-up tasks to ensure member or provider needs are fully met.

Skills Customer service, Microsoft office, bilingual

Additional Skills & Qualifications Required Qualifications:

High School Diploma Strong computer, technical, and data entry skills Experience with computer applications, such as Microsoft Word and PowerPoint. Previous customer service/call center experience is required.