Customer Service Representative II

Alaska Support Industry Alliance; Madison (WI); On-site; USD 32,000 - 52,000; Full time

Job summary

Alaska Support Industry Alliance is seeking a customer service professional to advocate for members, resolve inquiries, and support ongoing improvements within health insurance networks.

The role emphasizes independent handling of calls and emails, collaboration across departments, and providing resources to help consumers navigate health insurance networks. You will document interactions and contribute insights to enhance processes while maintaining a positive, helpful demeanor.

Responsibilities

• Maintains a positive and approachable demeanor in all customer interactions, showing a genuine interest in helping consumers and improving their experience.
• Helps member employees navigate their health insurance network providers.
• Independently provides customer service via telephone and email, answering questions and resolving issues related to electronic claims filing, repricing, network-related inquiries, and other established Customer Services processes.
• Refers consumers to the appropriate third-party administrator (TPA) or other resource for claims status, eligibility, or matters requiring assistance outside The Alliance’s scope.
• Provides education and resources to empower consumers to make informed health care decisions.
• Responds to written correspondence within established timeframes.

Job description

• Maintains a positive and approachable demeanor in all customer interactions, showing a genuine interest in helping consumers and improving their experience.
• Helps member employees navigate their health insurance network providers.
• Independently provides customer service via telephone and email, answering questions and resolving issues related to electronic claims filing, repricing, network-related inquiries, and other established Customer Services processes.
• Refers consumers to the appropriate third-party administrator (TPA) or other resource for claims status, eligibility, or matters requiring assistance outside The Alliance’s scope.
• Provides education and resources to empower consumers to make informed health care decisions.
• Responds to written correspondence within established timeframes.

How You Will Contribute

Customer Support & Advocacy

• Maintains a positive and approachable demeanor in all customer interactions, showing a genuine interest in helping consumers and improving their experience.
• Helps member employees navigate their health insurance network providers.
• Independently provides customer service via telephone and email, answering questions and resolving issues related to electronic claims filing, repricing, network-related inquiries, and other established Customer Services processes.
• Refers consumers to the appropriate third-party administrator (TPA) or other resource for claims status, eligibility, or matters requiring assistance outside The Alliance’s scope.
• Provides education and resources to empower consumers to make informed health care decisions.
• Responds to written correspondence within established timeframes.

Issue Resolution & Collaboration

• Researches customer questions and concerns using available systems and resources and identifies appropriate solutions or next steps.
• Independently resolves standard customer issues and determines when additional expertise, referral, or escalation is appropriate.
• Takes ownership of customer inquiries and supports timely follow-through and resolution.
• Accurately documents customer interactions, research, actions taken, and relevant information to support continuity of service.
• Collaborates with Customer Services staff, other departments, and appropriate external partners to resolve customer issues.

Customer Insights & Continuous Improvement

• Proactively collects and shares consumer feedback to identify recurring concerns and opportunities to improve the customer experience.
• Recognizes patterns in customer inquiries and communicates observations to the Director or other appropriate Alliance staff.
• Contributes ideas and feedback that support improvements to Customer Services processes, resources, and service delivery.
• Maintains proficient knowledge of The Alliance’s networks, services, systems, terminology, and Customer Services processes.
• Assists with data entry and other departmental responsibilities as needed.