Customer Service Representative

The Health Plan of West Virginia Inc; East Side (WV); On-site; USD 28,000 - 36,000; Full time

Job summary

The Health Plan of West Virginia Inc seeks a Customer Service Representative to answer 40–60 calls daily from members and providers. You will use medical terminology and coding knowledge (CPT/ICD, NDC) while delivering accurate information and timely correspondence.

The role requires strong communication skills and familiarity with the health care system, in a full-time on-site setting in Charleston, WV. Applicants should have a high school diploma, prior call center experience, and good PC

Qualifications

• High School Graduate preferred; 1–2 years college with health focus.
• Strong ability to relate to a variety of people non-judgmentally.
• Strong organizational, verbal, and written communication skills.
• Knowledge of the health care system is helpful.
• PC and keyboard skills required.
• Proficiency in English spelling and usage.

Responsibilities

• Takes an average of 40-60 calls daily.
• Uses the required application proficiently to perform duties as a Customer Service Representative.
• Maintains monthly monitoring score of 90% accuracy or above on the 17 Points of Excellence.
• Understands departmental policies and procedures.
• Performs tasks with minimal supervision and meets annual performance expectations.
• Maintains a positive attitude and good attendance.
• Documents calls according to guidelines.

Skills

Call center experience

Medical terminology

CPT ICD coding

NDC coding

Coordination of Benefits

Verbal and written communication

PC / keyboard skills

Education

High School Graduate

Tools

PC skills

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Customer Service Representative

Full Time Clerical Charleston, WV, US

2 days ago Requisition ID: 1619

The Customer Service Representative is responsible for answering phone calls in a prompt and courteous manner to achieve contractual obligations. Responsible for answering Member's and Provider's questions with a quick and accurate response. They are also responsible for timely completion of all correspondence and reporting functions associated with the Customer Service Department.

Required:

• High School Graduate: prefer 1-2 years college with interest or concentration in health field.
• Strong ability to relate with a variety of people in a non-judgmental manner.
• Strong organizational, verbal and written communication skills.
• Possess some knowledge of the health care system.
• Personal Computer (PC) and Keyboard skills.
• Proper usage of the English Language.
• Previous call center experience.
• Medical Terminology.
• CPT and ICD-9/ICD-10 Coding.
• Familiar with medical and hospital claims.
• Familiar with Prescription Coding (NDC).
• Familiar with Coordination of Benefits Ruling.

Responsibilities:

• Takes an average of 40-60 calls daily.
• Has established adequate proficiency in using the application necessary to perform the functions of a Customer Service Representative.
• Maintains monthly monitoring score of 90% accuracy or above on the 17 Points of Excellence.
• Demonstrates a complete understanding of departmental policies and procedures.
• Able to perform assigned tasks with minimal supervision.
• Meets requirements on annual performance evaluation.
• Consistently displays a positive attitude and acceptable attendance.
• Increasing improvement in performance and job knowledge.Documents calls according to departmental guidelines.

Equal Opportunity Employer

The Health Plan is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. The Health Plan strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. The Health Plan employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.