Customer Service Representative

Harris Computer; Maine; On-site; USD 19,000 - 28,000; Full time

Job summary

Harris Computer's eNoah unit seeks a Life and Health Claims Customer Service Representative to handle telephone and written inquiries, examine information, perform research, and adjudicate according to claims processing guidelines. You will interpret contract benefits for policyholders, agents and providers with professionalism.

You will maintain external contacts with policyholders, providers, agents, attorneys and other carriers and internal contacts with peers and supervisors.

Qualifications

• Examine, perform research and adjudicate inquiries per claims processing guidelines.
• Interpret contract benefits for policyholders, agents and providers with professionalism.
• Maintain external and internal contacts to support claims processing.

Responsibilities

• Interpret contract benefits accurately to policyholder, agents, and providers.
• Provide claim status to policyholders or providers.
• 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 for a clear 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.

Skills

Interpret contract benefits clearly

Provide claim status

Phone support

Documentation of calls

Cross training participation

Communication

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