Customer Service Representative

Harris Computer; Colorado; On-site; USD 23,000 - 25,000; Full time

Job summary

Harris Computer is seeking a Life and Health Claims Customer Service Representative. In this role you will examine, research and make the decisions necessary to adjudicate telephone and written inquiries, interpreting contract benefits per claims processing guidelines.

You will maintain information on benefits, policy decisions and communicate with policyholders, providers and internal teams to ensure accurate, timely responses to inquiries.

Qualifications

• Interpret contract benefits accurately to policyholders, agents, and providers.
• Provide claim status information with a professional approach.
• Answer calls in a helpful, professional, timely manner.
• Place outgoing calls as needed to obtain or provide information.
• Document calls and progression in the system to leave an audit trail.
• Coordinate calls with other departments to meet customer needs.
• Participate in cross training to maximize team efficiency.
• Communicate openly with Supervisors and Team Leads to ensure accurate responses.

Responsibilities

• Interpret contract benefits accurately to policyholders, agents, and providers.
• Provide claim status to policyholders or providers with a professional approach.
• Answer calls as required by company policy in a helpful, professional, timely manner.
• Place outgoing calls as needed to provide or obtain information.
• Document (written/on-line) all calls while in progress.
• Transfer calls to employees in other departments as required to meet customer needs.
• Fully document policy file or imaging system with all related material to leave a clear audit trail.
• Actively participate in cross training and group training sessions to maximize team efficiency.

Skills

Customer service

Claims processing

Communication

Record/documentation

Job description

eNoah, a Harris Computer company, is seeking a Life and Health Claims Customer Service Representative.
In this position you will examine, perform research and make the decisions necessary to properly adjudicate telephone and written inquiries. Interpret contract benefits in accordance with specific claims processing guidelines. Communicate problems identified relevant to the claims processing system to the appropriate people.
Receive, organize and make daily use of information regarding benefits, contract coverage, and policy decisions. Maintain external contacts with policyholders, providers of service, agents, attorneys and other carriers as well as internal contacts with peers, management, and other support areas with a
positive and professional approach.

• Interpret contract benefits accurately to policyholder, agents, and providers with a positive and professional approach.
• Provide claim status to policyholders or providers with a positive and professional approach.
• Answer calls as required by company policy in a helpful, professional, timely manner.
• Place outgoing calls as needed to provide or obtain information.
• Document (written/on-line) all calls while in progress.
• Transfer calls to employees in other departments as required to meet customer needs.
• Fully document policy file or imaging system with all related material so as to leave a clear and concise audit trail.
• Actively participate in cross training and group training sessions to maximize team efficiency and maintain or exceed service standards.
• Communicate openly with Supervisor, Team Lead and other team members to ensure accurate responses and avoid duplication of efforts.

Hourly Rate - $17.00