Customer Service Representative - Member Health Services

Burbank, CA 91510

Employment Type: Contract to Hire Category: Professional Services Job Number: WH-DC-CustServHeal01 Pay Rate: $18-22/hr

We seek high-level customer service representatives ASAP, insurance industry experience a PLUS, for our clients’ medical benefits department.

Our client provides vision, dental, psychiatric, medical and other healthcare benefits to members (and their dependents) of creative industries, including motion picture, television and commercial production. They are known for far-reaching efforts that contribute to the general health and well-being of all its members. Our client also has a long history of charitable involvement in the community and encourages employees to volunteer time to their own special interests or those supported by the organization (such as The Actors Fund and Alzheimer’s research).

Ideal candidates have solid call center experience, knowledge of medical terminology, are highly ethical and tactful. This role discusses claims, eligibility, and general plan information with members. Send us your resume for immediate customer service roles!

About the Position:

  • Call center
  • Answer high call volume
  • Data entry
  • Update existing records
  • Answer benefits questions from plan members
  • Review policy details
  • Verify benefit coverage and status
  • Assist with claims payment issues
  • Process medical, dental and vision claims
  • Contact 3rd party vendors to facilitate support requests (pharmacies, providers)
  • Research issues relating to payments, claims, benefits
  • Fax or reissue explanation of benefits to plan members
  • Provide updated information to claim examiners
  • Determine claims coverage using plan descriptions, medical reference books, guidelines
  • Provide Claims and Eligibility forms
  • Provide information using digital systems (CRT)
  • Provide billing history information
  • Take insurance payments by phone
  • Process insurance coverage change requests 
  • Follow organization’s data entry techniques and procedures
  • Maintain call logs
  • Follow call policies and manual
  • Build strong customer relationships
  • Answer questions and resolve problems
  • Respond to calls, emails, and live chats from customers
  • Special projects as requested

This is not a comprehensive list of duties.

About the Candidate:

  • High School Diploma or GED (MUST)
  • 1+ years’ experience working with medical terminology (MUST)
  • 2+ years’ experience working in call center (MUST)
  • 2+ years’ experience working with medical plans (PLUS)
  • 3+ years’ experience offering excellent customer service (MUST)
  • 1+ years’ experience heavy phones (PLUS)
  • Intermediate computer skills including MS Office (MUST)
  • Personality and characteristics: telephone, communication, ability to recognize and solve issues, planning, organization, and ability to work independently, professionalism, courteous

Equal Opportunity Employer considering qualified candidates in accordance with state and federal laws, including those with criminal histories, in a manner consistent with the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance.

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