Customer Service Representative
Responsible for researching and verifying Third Party Liability insurance and updates the state MMIS system.
Main Duties and Responsibilities:
Researches and verifies eligibility information via online lookups to carrier eligibility websites or by phone with various carriers and updates the state MMIS system.
Loads a minimum of 20-25 adds per day into the state MMIS system and terminates existing TPL insurance policies.
Answers incoming calls from providers, Medicaid recipients, and other entities in relation to private/commercial insurance.
Maintains an accuracy of 99% or above on all work activities per contractual obligation with state.
Performs other duties as assigned.Additional Essential Functions:
Ability to communicate both verbally and in writing, fluently in English.
Ability to be careful and thorough.
Ability to build relationships both in person and over the phone.
Ability to work proficiently with company software used on the project (i.E. Microsoft Word, Excel, ImageNow, etc.).
Ability to navigate various websites.
Average manual dexterity in use of a PC, phone, sorting, filing and other office machines.
Ability to sit and work at a computer for an extended period of time.
Working knowledge of HIPAA privacy and security rules.
Ability to organize well.
Ability to perform well in team environment.
Ability to work independently to meet objectives.
Ability to meet deadlines.
Develops effective working relationships with internal and external clients.
Meets attendance guidelines.
Adheres to corporate and office policies.
Maintains an accuracy of 99% or above on all work activities-per contractual obligation with state.
Proactively identify areas of improvements within daily work activities
Gain general understanding of HMS and office operations
High School Diploma or GED required; Associate s degree preferred.
Minimum Related Work Experience:
1+ years experience in insurance verifications.
Customer call center environment experience.
Knowledge of state Medicaid systems.