Customer Care Rep II - Fully Remote!

SKYGEN; Oregon; Ibrido; USD 21.000 - 30.000; Tempo pieno

Descrizione del lavoro

SKYGEN is seeking a fully remote Customer Service Representative to assist members with dental and vision benefits, eligibility, claims, and provider searches. The role emphasizes empathy, active listening, and clear communication.

Training starts CST 8:00am–4:30pm for 12 weeks; after training, varied start times (6:00am–10:30am CST) Mon–Fri with potential overtime and occasional evenings during Medicare Open Enrollment. Experience in healthcare insurance is preferred.

Competenze

• High school diploma or equivalent.
• 1+ years of customer service experience in healthcare, call center, banking or retail.
• Strong problem-solving with empathy and patience when listening to customers.
• Proficient with Microsoft Office (Word, Excel, Outlook).
• Ability to work overtime as needed and manage multiple tasks.

Mansioni

• Servicing Dental and Vision inbound callers with eligibility, coverage, authorizations, claims and provider location help.
• Understand claim adjustments and resubmission processes to resolve provider requests.
• Provide feedback to Provider Relations on high-level claim issues for prompt resolution.
• Support enrollment activities like assigning primary care providers and updating insurance information.
• Act as liaison with Member Services to resolve eligibility, appeals and grievances.
• Update providers on credentialing status and respond to questions.
• Educate callers on using provider web portals to access benefits.

Conoscenze

Empathy

Customer service

Listening

Communication

Typing

Data entry

Multi-tasking

Problem solving

MS Office

Formazione

High school diploma or equivalent

Descrizione del lavoro

Important things YOU should know:

Fully remote opportunity

Training schedule 8:00am - 4:30pm Monday – Friday CST for the 1st 12 weeks

Work schedule (after training): Multiple opportunities available with ranging start times from 6:00am CST to 10:30am CST Mon - Fri.

Hours of operation: 6:00am - 10:00pm CST Monday - Friday so shift could flex based on business need

$2.00/hour differential on Mon/Tues

Occasional evenings, weekends and holidays possible during Annual Medicare Open Enrollment: 10/1 - 3/31

Exceptional professional growth in a fun rewarding environment

Experience with Dental or Health insurance a preferred plus

What will YOU be doing for us?

Our Customer Service Representatives must have strong problem-solving skills, coupled with the natural ability to provide empathy for the customer – always taking the time to patiently listen and understand their questions to help find a viable solution, while providing them with a memorable customer experience.

What will YOU be working on every day?

• Servicing our Dental and Vision inbound callers with information regarding their eligibility, benefit coverage, authorizations, claims, and assisting them with locating a provider in their area
• Utilize knowledge of claim adjustments and resubmission processes to determine appropriate resolution to provider requests
• Provide feedback to Provider Relations staff on high-level claim issues including but not limited to issues with reimbursement schedules or conflicting information to ensure providers receive a prompt resolution
• Support enrollment activities including but not limited to assigning primary care providers, and updating third party insurance information
• Act as liaison between our organization and the client’s Member Services staff to resolve issues such as eligibility and filing appeals and grievances
• Provide updates to providers with questions regarding the status of their credentialing application
• Recognize provider questions that could be handled through the use of the provider web portal and provide education to these callers on the benefits of utilizing the technology available
• Ensure all calls are answered according to company and client guidelines
• Accurately document call information and resolution in our internal systems
• Apply effective diffusion techniques when necessary to ensure our customers feel heard, valued and supported
• Properly identify issues that need to be escalated appropriately to the leadership team

Additional Responsibilities:

• Provide recommendations on system enhancements and process improvements to management
• Keep our Provider Relations team updated with provider manual discrepancies, change in locations or any other provider related issues
• Participate in departmental projects when applicable

Required Level of Education, Licenses, and/or Certificates

• High school diploma or equivalent

Required Level of Experience

• 1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail

Required Knowledge, Skills, and Abilities

• Basic knowledge of Microsoft Office products including but not limited to Word, Excel, and Outlook.
• Ability to work occasional overtime as needed.
• Excellent listening and communication skills.
• Superior customer service skills including the natural ability to provide empathy.
• Strong data entry/typing skills.
• Strong navigation skills and the ability to multi-task.
• Excellent attention to detail.
• Critical thinking skills to quickly analyze and clearly understand a specific request or customer need and then leverage knowledge and resources to provide the appropriate solutions.

Preferred Level of Experience

• 1+ years of job related customer service experience within the dental, vision or medical industry.
• Previous experience working in a virtual environment.
• Understanding of dental, vision and/or medical insurance terminology.

SKYGEN is the trusted partner for specialty benefits payers and government agencies responsible for the delivery and administration of dental and vision benefits. Through cutting-edge technology and service solutions, SKYGEN empowers clients to become the most efficient, effective healthcare organizations in the country.

Equal Opportunity Employer, including Protected Veterans and Individuals with Disabilities.