Customer Service Representative (Eligibility & Benefits)

This is a great opportunity for someone fairly new to the workforce or someone looking to learn a new industry or career. We are looking for a part time person ideally 24-28 hours per week. About the

Company:

Since 1967, the Diversified Group has been the industry pioneer in discovering and creating innovative solutions to evolving healthcare demands. Diversified Group strives to be an employer of choice, has long-tenured staff and offers a great benefits package, including an on-site gym and fitness classes. More information about the company can be found at www.dgb-online.com. About the

Job:

The Eligibility and Benefits Representative fields calls from members and providers regarding health insurance benefit coverage. If you have exceptional phone etiquette and some experience in medical terminology or health insurance claims or interest in learning, we encourage you to apply.

Overview:

Provide exceptional customer service to members and providers in a professional and courteous manner. Answer calls from members and providers to verify coverage, benefits, eligibility and coordinate with other departments as needed. Review plan documents to quote benefits coverage available for members and providers. Contact claims adjuster to question errors as necessary regarding claims. Contact health insurance plan liaison to make corrections in pricing from network. Initiate precertification review of benefits. Provide customer service to members who do not have computer access by reviewing the health insurance plan's website for in-network provider information. Document calls in company's computer system. Analyze customer inquiries and provide appropriate solutions or recommendations

Required Qualifications:

Strong communication skills, both verbal and written. Ability to analyze customer needs and provide appropriate solutions. Excellent problem-solving skills. Strong time management and organizational skills. Proficiency in MS Office products, including Outlook, Word and Excel. Some experience in healthcare or insurance and familiarity with medical and claims terminology is preferred but not required. Familiarity with health insurance plan documents, eligibility terms and plan provisions is a plus! If you are a motivated individual who enjoys learning and working in a fast-paced environment and providing exceptional customer service, we would love to hear from you. This job is on-site in Marlborough, CT.

Pay:

$20.00 - $23.00 per hour

Benefits:

401(k) Dental insurance Health insurance Paid time off Vision insurance

Experience:

Customer Service:

1 year (Preferred)

Health Insurance:

1 year (Preferred) Ability to

Commute:

Marlborough, CT 06447 (Required)

Work Location:

In person