Call Center Representative – The Health Plan

We are searching for a Call Center Representative – someone who works well in a fast-paced setting. This position will serve as a Member and/or Provider Advocate by possessing knowledge and understanding of the organization’s processes, policies, and procedures. This role will investigate, resolve and/or facilitate resolution of simple to moderately complex issues and/or questions reported by departments within the organization. You will be the first point of contact for assistance and/or information regarding eligibility, benefits, authorizations, claims, referrals and any other needs. This position will assist and advocate for members and/or providers throughout the complaint and appeal process and assist members with timely appointment scheduling.

Think you’ve got what it takes?

• Supports the organizations call center’s day to day operation
• Educates members about their health coverage benefits and services
• Empowers members by directing them toward available resources for self-help
• Ensures departmental expectations for knowledge, training and outcomes are met
• Maintains confidentiality of the member’s personal health information

• H.S. Diploma or GED required
• 1-year customer service experience within managed care or insurance industry required or
• 1-year call center experience in any industry