Customer Service Representative

Harris Computer; Wyoming (OH); On-site; USD 46,838,000 - 52,349,000; Full time

Job summary

eNoah, a Harris Computer company, seeks a Life and Health Claims Customer Service Representative to adjudicate inquiries and interpret contract benefits under guidelines. You will maintain information on benefits, coverage, and decisions, and communicate with policyholders, providers, agents, attorneys and carriers with professionalism.

The role emphasizes handling inquiries, providing timely claim status, and ensuring accurate documentation and audit trails within a collaborative team.

Responsibilities

• Interpret contract benefits accurately for policyholders, agents and providers.
• Provide claim status updates to policyholders or providers.
• Answer calls in a helpful, timely manner per company policy.
• Place outgoing calls to obtain or provide information as needed.
• Document all calls and interactions for audit trails.
• Transfer calls to other departments to meet customer needs.
• Document policy files thoroughly to maintain a clear audit trail.
• Participate in cross-training sessions to maximize team efficiency and maintain service standards.

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