FEP Benefit Processor / Customer Service Representative Trainee

RadNet, Inc.; Kapolei (HI); On-site; USD 42,000 - 52,500; Full time

Job summary

Hawaii Medical Service Association in Hawaii seeks a FEP Benefit Processor/CSR Trainee to provide support by phone, in person, and by written correspondence. The position is full-time and non-exempt, with a pay range of $42,000 to $52,500.

New hires typically start toward the minimum to middle of the range. Responsibilities include assisting members and providers with enrollment, benefits, and claims processing, and gaining knowledge of standard procedures and systems such as QNXT, Documentum,

Qualifications

• High school diploma or GED and 18 months of work experience or equivalent.
• Effective verbal and written communication skills.
• Requires attention to detail and ability to manage multiple projects.

Responsibilities

• Respond to inquiries on enrollment, benefits and claims processing.
• Use multiple systems to research information and provide accurate responses.
• Complete FEP training with at least 90% within 1 year of hire.

Skills

Verbal and written communication

Attention to detail

Multitasking

Education

High school diploma or GED

Equivalent combination of education and experience

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

#26-6168

Employment Type

Full-time

Exempt or Non-Exempt

Non-exempt [Non-ex.]

Job Summary

Pay Range:$42,000 - $52,500

Note:Individuals typically begin between the minimum to middle of the pay range

The FEP Benefit Processor/CSR Trainee is responsible for providing assistance to our Member and Providers by telephone, in-person, and written correspondence. Expected servicing requirements include accurate and timely responses to ensure a level of satisfaction that meets or exceeds our FEP contractual performance requirements. Work impacts the timeliness, quality and cost of work in the department and contributes towards HMSA's mission to deliver exceptional service and outstanding results to our customers.

Gain working knowledge (learned through successful completion of training and on-the-job) of standard procedures, products, rules and instructions to perform full range of assignments. Respond to inquiries and resolve recurring problems that include enrollment, benefits and claims processing information and procedures.

The Trainee must successfully complete training and exhibit the necessary skills to perform essential duties and other tasks expected of this position. Completion of the FEP training examination with a score of no less than 90% is required within one year of hire.

Minimum Qualifications

• High school diploma or GED and eighteen months of work experience or an equivalent combination of education, and experience.
• Effective verbal and written communication skills.
• Requires attention to detail and the ability to work on multiple projects simultaneously.
• Working knowledge of general office practices and procedures.
• Basic knowledge of Microsoft Office applications. Including but not limited to Word, Excel, and Outlook.
• Must complete the FEP training examination with a score of no less than 90% within one (1) year of hire.

Duties and Responsibilities

• Successfully progress through and complete on-the-job training to respond verbally, in person and in writing to internal and external customer's inquiries on enrollment, eligibility, benefits and claims adjudication questions in a professional, accurate and timely manner.
• Review, assess and deliver accurate and timely responses to eligibility, benefit and basic claims status inquiries using multiple systems and resources to research information (i.e., QNXT, Documentum, 837 Database, Mainframe, ASSIST, FEPDirect, FEPBlue.org, BlueWeb.org, PC software).
• Effectively apply reasoning and problem solving and successfully complete interactions with internal and external customers to achieve high quality customer‑centric delivery of service. This will include:
  
  • Efficiently and comprehensively identify the inquirer's reason for contacting us. Adapt our response delivery to address all issues in a positive and helpful manner providing information and education of clarifying concepts when necessary. Share our internal expertise of the benefit and processes to resolve Member and Provider inquiries.
  • Apply sound decision making to request and compile appropriate supporting documentation as required by the FEP Director's Office or the FEP Operations Center to update, correct or initiate member enrollment or demographic information, plan primacy order, servicing authorization, TPL case pursuit, and other documentation as needed.
  • Collaborate with internal departments that support FEP benefit and claims processing activities such as Medical Management, Customer Relations and Finance & Accounting to ensure consistent delivery of information and services.
• Performs all other miscellaneous responsibilities and duties as assigned or directed.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact808-948-5588 or via email at [e-mail].

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