Receive, answer and/or record telephone/correspondence/e-mail inquiries from subscribers, providers, and other consumers relating to areas of coverage, payment of claims, membership status, medical management intake calls, etc., under the various EmblemHealth medical/surgical, dental, hospital and Medicare plans.
Review inquiries, correspondence and email receipts. Prepare email resolutions, letters (form or narrative letter) and/or claims payment process adjustments.
Perform written and verbal duties of the position to meet company goals for production and accuracy.
Perform other duties as assigned or required.
Principal Accountabilities Must be able to work under pressure, handle stressful situations effectively and deal politely with subscribers and providers on the telephone, in person, and email/correspondence.
Perform related claims approving and clerical work as assigned.
Qualifications Education, Training, Licenses, Certifications
A college degree is preferred.
Relevant Work Experience, Knowledge, Skills, and Abilities
A minimum of two (2) years' experience in customer service; one year must be in a call center setting.
Ability to detect and relate problem service issues to management.
Ability to speak well on the telephone and maintain a positive telephone personality.
Must be able to compose clear concise letters.
If designated, sort and screen correspondence receipts and resolve via coding of additional payment, possibly including salvage and/or completion by letter.
Typing and PC skills.
Ability to adapt to change and address multiple issues simultaneously.
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Review inquiries, correspondence and email receipts. Prepare email resolutions, letters (form or narrative letter) and/or claims payment process adjustments.
Perform written and verbal duties of the position to meet company goals for production and accuracy.
Perform other duties as assigned or required.
Principal Accountabilities Must be able to work under pressure, handle stressful situations effectively and deal politely with subscribers and providers on the telephone, in person, and email/correspondence.
Perform related claims approving and clerical work as assigned.
Qualifications Education, Training, Licenses, Certifications
A college degree is preferred.
Relevant Work Experience, Knowledge, Skills, and Abilities
A minimum of two (2) years' experience in customer service; one year must be in a call center setting.
Ability to detect and relate problem service issues to management.
Ability to speak well on the telephone and maintain a positive telephone personality.
Must be able to compose clear concise letters.
If designated, sort and screen correspondence receipts and resolve via coding of additional payment, possibly including salvage and/or completion by letter.
Typing and PC skills.
Ability to adapt to change and address multiple issues simultaneously.
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