Claims Customer Service Representative

The Benefit & Claims Customer Service Representative provides information on health and welfare, benefits and claim status to hospitals, providers, and participants. Additionally this position will be responsible for providing high quality customer service while documenting telephone, written and walk-in inquiries regarding benefits, or claim status in an efficient, prompt and professional manner.

Responsibilities

Customer Service

• Provide high quality customer service to all Fund members by documenting telephone, written and walk-in inquiries regarding benefits, or claim status in an efficient prompt and professional manner.
• Respond to and resolve complex issues, including those escalated by members.
• Serve as primary, daily contact to clients on delivery of services.
• Resolve complex plan provision questions and issues addressed.
• Raise issues as appropriate to Team Supervisor or Department Manager.
• Learn and use professional excellence tools and concepts to ensure efficient and quality output/service delivery.

Teamwork

• Work cooperatively with other team members.
• Actively participate in team meetings and training activities.
• Perform additional responsibilities and projects as periodically assigned.