Health Plan ESR: Escalations & Member Support

The Health Plan (THP); Wheeling (WV); On-site; USD 35,000 - 50,000; Full time

Job summary

The Health Plan is seeking an Employer Service Representative (ESR) to handle complex and escalated inquiries from members, providers, and employers. You will build rapport, research issues, and ensure accurate information while maintaining confidentiality.

Must be detail oriented, able to work independently, and collaborate with the team. Experience in health insurance and CPT/ICD knowledge are desirable, with proficiency in Microsoft Office.

Qualifications

• High School graduate or equivalent, proficient computer use, strong written etiquette.
• Excellent communication skills, both oral and written, with the ability to resolve escalated inquiries.

Responsibilities

• Answer calls and written correspondence in a timely, professional manner.
• Communicate with clients, members and providers to obtain information to resolve issues.
• Research claim processing errors and process network settlements with self-funded networks.

Skills

Oral and written communication

Detail oriented

Problem solving

Self-starter

Time management

Confidentiality

MS Office proficient

Team collaboration

Prioritize deadlines

Computer literacy

Education

Bachelor’s degree

Tools

Microsoft Office

Job description

The Health Plan is seeking an Employer Service Representative (ESR) to handle complex and escalated inquiries from members, providers, and employers. You will build rapport, research issues, and ensure accurate information while maintaining confidentiality.

Must be detail oriented, able to work independently, and collaborate with the team. Experience in health insurance and CPT/ICD knowledge are desirable, with proficiency in Microsoft Office.