Customer Service Representative

The Health Plan (THP); Wheeling (WV); On-site; USD 30,000 - 40,000; Full time

Job summary

The Health Plan (THP) is seeking a Customer Service Representative in Wheeling, WV. In this role, you will handle 40-60 calls daily, providing accurate and timely responses to members and providers. Candidates should have a High School diploma with strong communication and organizational skills, preferably with experience in a call center and knowledge of medical terminology. This position offers a full-time schedule from 8:00 am to 5:00 pm.

Qualifications

• Proficient in using the required applications for customer service.
• Able to maintain high accuracy and meet performance evaluations.
• Strong ability to engage with various people in a professional manner.

Responsibilities

• Answer 40-60 calls daily from members and providers.
• Ensure timely completion of correspondence and reporting.
• Document calls according to departmental guidelines.

Skills

Verbal Communication

Organizational Skills

Written Communication

Interpersonal Skills

Knowledge of Health Care System

Education

High School Graduate

1-2 years college in health field

Tools

Personal Computer

Job description

Overview

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.
• Courteous manner/even temperament.
• Excellent communication skills.

Desired

• 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.

Hours: 8:00am - 5:00pm

Positions available: 40