Overview
Seeking a Call Center Representative. Call Center Representatives provide accurate and thorough information on plan benefits, eligibility, and claims. You will handle inbound and outbound calls as well as respond to email inquiries from our customers. In this role, you may be responsible for developing process, call scripts, metrics, and desktop procedures. The role is responsible to deliver an exceptional customer service experience to our members and providers. This role reports to the Sr. Director Claims and Customer Support and Manager of Claims and Customer Support. Fully Remote - 9AM-5PM CST hours.
Key Responsibilities
Research, reviews and responds to inquiries received from members and providers. Employs active listening skills, demonstrates patience and empathy, and can handle difficult calls tactfully, courteously and professionally. Effectively manages escalations within the department by ensuring accountability, sense of urgency, communication and follow through to closure. Leverages company policies and procedures, benefits, claims, and eligibility to respond accurately to all inquiries. Handles member complaints and complaint appeals. Works with internal departments, vendors, business partners, providers, etc. to coordinate problem solving in a timely manner. Demonstrates basic understanding of company billing guidelines and can interpret inquiries related to claims and claim payments. Accurately documents all calls. Recognizes trends and patterns in call types and engages leadership with suggested solutions. Meets and maintains established department production and quality standards, on an individual and team basis. Assists members with navigating the member portal and encourages self-sufficiency with tools. Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations. Ability to excel in a virtual work environment through active participation in team huddles, 1:1s, instant messaging, or check-ins.
Experience and Skills Desired
Minimum of 2 years customer service experience. Knowledge of medical and insurance industry terminology including CPT/ICD-10, HCPCS and Revenue Codes. Excellent communication skills, both verbal and written; able to articulate complex topics to a broad audience. Ability to perform in a fast-paced, deadline-oriented environment. Strong attention to detail and problem-solving skills with a high level of accuracy. Collaborates with Claims, Medical Management, Appeals and Grievance units. Proficient in Microsoft Office applications (Word, Excel, Outlook, OneNote). Experience using a CRM, preferably Salesforce. Bonus: fluency in Spanish.
Telecommuting Requirements
Dedicated work area established that is private and information secure. Ability to keep all company sensitive documents secure. Must live in the United States. Must live in a location with existing high-speed internet access.
Location and Benefits
This is a remote position; the company operates remotely. Company business hours are weekdays 9-5 CST. Full benefits package including health insurance, 401(k) matching, vision, dental, life, disability, and vacation.
Apex Systems is a world-class IT services company that serves thousands of clients across the globe. We value innovation, collaboration, and continuous learning. We offer career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our awards include ClearlyRated’s Best of Staffing in Talent Satisfaction (U.S.) and Great Place to Work in the United Kingdom and Mexico. Apex uses a virtual recruiter as part of the application process.
Equal opportunity employer information: Apex Systems is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, creed, sex, age, sexual orientation, gender identity, national origin, disability, or other protected characteristics. For accommodations, contact our Benefits Department at [email protected] or 804-523-8228.
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Seeking a Call Center Representative. Call Center Representatives provide accurate and thorough information on plan benefits, eligibility, and claims. You will handle inbound and outbound calls as well as respond to email inquiries from our customers. In this role, you may be responsible for developing process, call scripts, metrics, and desktop procedures. The role is responsible to deliver an exceptional customer service experience to our members and providers. This role reports to the Sr. Director Claims and Customer Support and Manager of Claims and Customer Support. Fully Remote - 9AM-5PM CST hours.
Key Responsibilities
Research, reviews and responds to inquiries received from members and providers. Employs active listening skills, demonstrates patience and empathy, and can handle difficult calls tactfully, courteously and professionally. Effectively manages escalations within the department by ensuring accountability, sense of urgency, communication and follow through to closure. Leverages company policies and procedures, benefits, claims, and eligibility to respond accurately to all inquiries. Handles member complaints and complaint appeals. Works with internal departments, vendors, business partners, providers, etc. to coordinate problem solving in a timely manner. Demonstrates basic understanding of company billing guidelines and can interpret inquiries related to claims and claim payments. Accurately documents all calls. Recognizes trends and patterns in call types and engages leadership with suggested solutions. Meets and maintains established department production and quality standards, on an individual and team basis. Assists members with navigating the member portal and encourages self-sufficiency with tools. Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations. Ability to excel in a virtual work environment through active participation in team huddles, 1:1s, instant messaging, or check-ins.
Experience and Skills Desired
Minimum of 2 years customer service experience. Knowledge of medical and insurance industry terminology including CPT/ICD-10, HCPCS and Revenue Codes. Excellent communication skills, both verbal and written; able to articulate complex topics to a broad audience. Ability to perform in a fast-paced, deadline-oriented environment. Strong attention to detail and problem-solving skills with a high level of accuracy. Collaborates with Claims, Medical Management, Appeals and Grievance units. Proficient in Microsoft Office applications (Word, Excel, Outlook, OneNote). Experience using a CRM, preferably Salesforce. Bonus: fluency in Spanish.
Telecommuting Requirements
Dedicated work area established that is private and information secure. Ability to keep all company sensitive documents secure. Must live in the United States. Must live in a location with existing high-speed internet access.
Location and Benefits
This is a remote position; the company operates remotely. Company business hours are weekdays 9-5 CST. Full benefits package including health insurance, 401(k) matching, vision, dental, life, disability, and vacation.
Apex Systems is a world-class IT services company that serves thousands of clients across the globe. We value innovation, collaboration, and continuous learning. We offer career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our awards include ClearlyRated’s Best of Staffing in Talent Satisfaction (U.S.) and Great Place to Work in the United Kingdom and Mexico. Apex uses a virtual recruiter as part of the application process.
Equal opportunity employer information: Apex Systems is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, creed, sex, age, sexual orientation, gender identity, national origin, disability, or other protected characteristics. For accommodations, contact our Benefits Department at [email protected] or 804-523-8228.
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