Healthcare Call Center Specialist

The Health Plan of West Virginia Inc; Wheeling (WV); On-site; USD 32,000 - 41,000; Full time

Job summary

The Health Plan of West Virginia Inc is seeking a Customer Service Representative in Wheeling, WV. This full-time clerical role handles 40-60 incoming calls daily and supports the Customer Service Department with timely responses to members and providers.

Qualifications include a high school diploma, healthcare-focused education, CPT/ICD-10 knowledge, and prior call center experience. Strong communication and computer skills are required to maintain accuracy and quality in every interaction.

Qualifications

• High school diploma or equivalent.
• 1-2 years post-high school education focused on healthcare.
• Previous call center experience.
• Knowledge of CPT and ICD-10 coding.
• Familiar with medical and hospital claims.

Responsibilities

• Takes an average of 40-60 incoming calls daily.
• Keep pended work at tolerable range (when applicable).
• Manage to work correspondence, faxes and e-mails in a timely manner.
• Maintains monthly monitoring score of 90% accuracy or above on the 17 Points of Excellence.
• Demonstrates a complete understanding of departmental policies and procedures.
• Able to perform assigned tasks with minimal supervision.
• Meets requirements on annual performance evaluation.
• Increasing improvement in performance and job knowledge.
• Documents calls according to departmental guidelines.

Skills

Customer service

Healthcare knowledge

Communication

Call center experience

Education

High school diploma

Post-secondary healthcare education

Tools

Computer skills

Typing/keyboard skills

Job description

The Health Plan of West Virginia Inc is seeking a Customer Service Representative in Wheeling, WV. This full-time clerical role handles 40-60 incoming calls daily and supports the Customer Service Department with timely responses to members and providers.

Qualifications include a high school diploma, healthcare-focused education, CPT/ICD-10 knowledge, and prior call center experience. Strong communication and computer skills are required to maintain accuracy and quality in every interaction.