Flexible Schedule Job Customer Engagement Representative Job ID- 1975

MaziCTools; United States; Hybrid; USD 36,000 - 56,000; Full time

Job summary

Ampcus Inc. is seeking a Customer Engagement Representative to support member services and claims inquiries in a fast-paced environment in the USA.

You will process enrollment transactions, resolve billing issues, and collaborate with clinical teams on managed care interventions; a High School diploma and 1 year of customer service experience are required.

Qualifications

• High school diploma or GED required.
• 1 year of customer service or claims experience.
• Inbound call center experience preferred.
• Exposure to health insurance and medical information preferred.

Responsibilities

• Answer member inquiries and resolve service problems.
• Examine claims to determine processing requirements and handle overpayments/underpayments.
• Learn enrollment transactions and generate accurate billing for policies.
• Identify eligible clients for managed care interventions with clinical collaboration.

Skills

Customer service

Communication skills

Problem solving

Organizational skills

Relationship management

Education

High School Diploma or GED

Job description

Industry: Private

Employment Type:- Full Time

Work Hours:- 8 Hours

Locations:- USA

Full Job Description

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team.

The Rep, Member Service is proficient in routine benefits, claims, and general inquiries. They have a general knowledge of the following: systems, benefits, contracts/products, functions of other departments in the company, standard operating procedures, claims status, enrollment/billing and follow-up to a customer inquiry.

Essential Functions

• 25% Answers member inquiries by clarifying desired information; researching, locating, and providing information. Resolves member service problems by clarifying issues; researching and exploring answers and alternative solutions; implementing solutions; escalating unresolved problems.
• 25% Examines claims to identify key elements, and processing requirements based on diagnosis, procedures, provider, medical policy, contracts, and policy and procedures. Calculates deductibles, maximums, and determining resolving, reporting, and following through on overpayments, underpayments, and managed care processes.
• 25% Learns and executes enrollment transactions in accordance with contractual and medical underwriting guidelines, generating accurate billing for policies and products purchased by new clients, existing clients, and transfers from other Client Plans. Learns the details of offering and administering various billing transactions, i.e. direct pay, credit card payment, and debit accounting through the policyholders checking account, and how to effectively interact with or advise clients, group administrators, brokers, or providers on problem resolution.
• 25% Identifies clients who are eligible or in need of managed care interventions and collaborates with the clinical professionals in designing and implementing the intervention.

Qualifications

Education Level

High School Diploma or GED

Experience

1 year customer service, claims experience, Inbound Call Center Experience

Preferred Qualifications

Experience performing duties that are detailed in nature, exposure to health, health insurance, medical information, and direct service experience is preferred.

Knowledge, Skills And Abilities

Self-starter with strong organizational skills and planning skills., Proficient.

Ability to maintain effective interpersonal relationships, Proficient.

Ability to recognize, analyze, and solve a variety of problems., Proficient.

Excellent communication skills both written and verbal., Proficient.

Maintains quality customer services by following customer service practices; responding to customer inquiries.

Ampcus is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, age, protected veterans or individuals with disabilities.

Customer Engagement Representative

Flexible Schedule Job Customer Engagement Representative Job ID- 1975