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We are actively seeking a customer service professional to join a team dedicated to helping our members and their families every day. In this role as a Customer Service Representative, you'll join us on a mission to not only deliver the best customer service in the industry, but the best customer service, Period. Your compassion and customer service expertise combined with our support, training and development will ensure your success.

Primary Responsibilities:

• Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)

• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems

• Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member

• Review and research incoming healthcare claims from members and providers (doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)

• Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)

Required Qualifications:

• High School Diploma / GED (or higher)

• 1+ years customer service experience in an office or professional setting preferred.

• •Due to the client base for this position, we require empathy, patience, and a positive attitude.

• Problem solving, organizational know how and collaboration skills, as the CSR is the liaison between the members, providers, and pharmacies, as well as other carriers to resolve claim and prescriptions issues.

• Reps should have basic computer skills for database and website navigation, Microsoft outlook, word and excel knowledge.

• Preferred Qualifications: Familiarity with medical terminology, Insurance terminology, Medicare & Part D plans

Details:

• Pay: $17 - $18/hr. based on related experience

• Pay cycle – weekly | medical, dental & vision benefits offered.

• Schedule: Monday – Friday | 10:00 am – 6:00pm

Added company perks:

• After 6 months the organization pays 100% of health insurance benefits.

• Monday – Friday schedule | No weekends

• Lunch is catered free of charge daily.

  About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.