Customer Service Representative

ih; United States; Hybrid; USD 25,000 - 30,000; Full time

Job summary

Independent Health is seeking a Customer Service Representative to assist members with inquiries, benefits, and eligibility across multiple databases, using empathetic listening and accurate documentation.

Training lasts about 10 weeks on-site in Williamsville, NY, Monday–Friday, 8:00 AM–4:30 PM. After training, the role transitions to a hybrid work arrangement with shifts between 8:00 AM and 8:00 PM and possible overtime.

Qualifications

• High school diploma or GED required.
• Prior customer service experience required.
• Call center experience preferred.
• Knowledge of CPT codes, ICD-9 coding, and medical terminology preferred.
• Excellent written and verbal communication; ability to work collaboratively.
• Proficient in Microsoft Office; able to talk and type simultaneously.

Responsibilities

• Serve customers and de-escalate as needed.
• Relay accurate and up-to-date information on policies and procedures.
• Document all calls accurately and timely.
• Escalate issues according to policy.
• Meet or exceed quality, productivity, accuracy, and call-identification goals.
• Maintain knowledge of contracts and benefits and related updates.
• Attend required training sessions (remote or onsite).
• Use multiple systems to retrieve information (Claims, Enrollment, Authorizations, Finance, AR, Providers).

Skills

Customer service

Communication

Problem solving

Time management

Attention to detail

Education

High school diploma

GED

Tools

Microsoft Office

Job description

FIND YOUR FUTURE

We’re excited about the potential people bring to our organization. You can grow your career here while enjoying first‑class perks, benefits and a culture that fosters growth, innovation and collaboration.

Training

Approximately 10 weeks of paid, on‑site training.

Monday‑Friday, 8:00AM - 4:30pm

Location: 250 Essjay Rd., Williamsville, NY

Schedule

After training, this role transitions to a hybrid work arrangement

You’ll be assigned a regular shift between 8:00 AM and 8:00 PM

Shift Preferences will be discussed after training

Occasional Overtime may be required, including holidays and weekends, based on business needs

Pay Rate

$19 per hour

Immigration or work visa sponsorship will not be provided for this position.

Overview

The Customer Service Representative (CSR) is responsible for displaying confidence, passion for service, and practicing empathetic listening while connecting to Independent Health members. The CSR actively listens, assesses needs and utilizes system tools and resources to address and resolve inquiries. In addition, the CSR makes appropriate process or regulatory determinations and follows escalation procedures when deemed appropriate. The CSR is called on to research complex issues pertaining to benefits, claims, plans, and eligibility across multiple databases which requires fluency in computer navigation and toggling while confidently and compassionately engaging with the member.

Qualifications

• High school diploma or GED required.
• Prior experience and success working in a customer service focused environment required.
• Previous experience working in a call center preferred.
• Knowledge of CPT codes, ICD-9 coding, and medical terminology preferred.
• Excellent written and verbal communication skills. Ability to communicate with internal and external customers effectively and efficiently. Must be able to work collaboratively.
• Ability to think critically and listen with intent to understand.
• Ability to adapt behavior based on constructive feedback to improve job performance.
• Proficient in problem solving and ability to prioritize accordingly.
• Microsoft Office experience required with the ability to talk and type simultaneously. Must demonstrate proficiency in balancing keyboard accuracy with speed, the ability to correctly transmit data, and the ability to work efficiently while producing excellent customer service experiences.
• Strong organizational and time management skills.
• Ability to assume responsibility and maintain confidentiality. Strong sense of accountability is required.
• Flexibility to work additional hours as required by department. Flexibility in shift assignment required. Must have availability to work a shift between 8:00 a.m. and 8:00 p.m. during normal business hours. Weekend shifts and holidays may occasionally be required.
• Ability and willingness to meet with customers face to face at alternate locations when business needs require.
• Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable.

Essential Accountabilities

• Service Customers
• Provide excellent customer service when responding to customers and de‑escalate customers as needed.
• Relay accurate and up‑to‑date information on policies and procedures and communicate a successful resolution to inquiries.
• Document all calls accurately and timely.
• Escalate issues to the appropriate resources as outlined in policy and procedure guides .
• Meet or exceed all quality, productivity, accuracy, and call identification goals as stated in the most current departmental policy .
• Maintain Core Knowledge
• Maintain technical knowledge regarding Independent Health's contracts and benefits and working knowledge of policies, procedures, and updates daily.
• Attend required training sessions as needed ( including remote and onsite learning) .
• Provide accurate and up‑to‑date information to all customers by documenting all pertinent information into appropriate systems to meet regulatory agency standards.
• Technology Requirements
• Utilize multiple systems and tools to obtain needed information related, but not limited to: Claims.
• Enrollment.
• Authorizations.
• Finance.
• Accounts Receivable.
• Reference Screens.
• Providers.
• Ability to determine claim status and whether claim is adjudicated properly. Must have knowledge and ability to make claim adjustments using established criteria.
• Compensation may vary based on factors including but not limited to skills, education, location and experience.
• In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.

As an Equal Opportunity / Aff…