Nashville, Tennessee
Call Center Agent Job Opening in Nashville, Tennessee - We are looking for inbound and outbound telephone representatives for our Call Center of Excellence!
Excellent People
Excellent Service
Excellent Place to Work
Excellent Pay and benefits
What we need now is YOU.. an "experienced and qualified" call center agent!
The ideal candidate will have healthcare insurance experience and at least three-years of experience working as a call center agent.
Summary: The Call Center Agent (customer service phone representative) is a key part of the company?s successful operation. The Agent is in daily contact with members, clients and providers, and are very often the initial contact with our office. A cheerful, competent and compassionate attitude will directly impact the satisfaction level of our clients and retention of our accounts. Attendance can also directly impact the satisfaction level of our clients and retention of our accounts.
Essential Duties and Responsibilities: Include the following. Other duties may be assigned.
Handle incoming and outbound group health plan customer service calls
Provide e-Payables support to various providers as well as cross sell them on the benefits
Answer questions concerning claims status, medical pre-certification and e-Payment
Interpret benefit eligibility based on Summary Plan Descriptions
Explain benefit determinations
Contact providers, clients and insurance carriers as needed
Research written and verbal inquiries in response to complex customer calls
Answers phone calls utilizing efficient interpersonal and communication skills, as well as excellent telephone and customer service skills and etiquette.
Exhibits attention to detail and a strong work ethic.
Manages time and resources efficiently and effectively.
Maintains effective working relationships with our callers and co-workers; always ethical, professional and courteous.
Participates as a Team Member to ensure the smooth operation of the entire department.
References internal and external proprietary systems to obtain claim and eligibility information.
Maintains and enters notes with details and accuracy on call log tracking application.
Answers a minimum of 76 calls per shift.
Utilizes internal databases to provide efficient and effective information.
Analyzes claim and eligibility information in the Luminx system.
Handles competently all calls including issues and high dollar claims.
Assesses and handle challenging callers and/or any other calls which may need to be escalated to the manager. In the case of the manager?s absence, report to the customer service team lead.
Complies with company policies and procedures as outlined in the Employee Handbook.
Complies with department policies and procedures.
Performs special projects at the request of management.
Regular, predictable attendance is required.
Ability to get along and work effectively with others.
Expectations
Maintain up to date and thorough knowledge of employee benefit provisions for group health plans including medical, dental, vision and prescription drugs
Answer questions concerning e-Payment, assist clients with navigating e-Payment portal, explain the advantages of receiving e-Payment
Demonstrate excellent communication, troubleshooting, listening and problem solving skills
Ability to multi task and prioritize
Utilize system programs appropriately
Meet the performance standards established for the position in the areas of : quality, accuracy, production, participant satisfaction and attendance
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience: High school diploma or general education degree (GED); or one to three years related experience and/or training; or equivalent combination of education and experience. Knowledge of Luminx system (a plus) and Basic Health Insurance terminology. Call center or customer service office environment. Collection, sales call center knowledge, medical experience, strong computer skills.
Language Skills: Good command of the English language. Ability to read and comprehend simple instructions, short correspondence and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
Mathematical Skills: Ability to add and subtract two digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance.
Reasoning Ability: Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.
Computer Skills: To perform this job successfully, an individual should have knowledge of Internet software and the Microsoft Office Suite of products. Knowledge of basic office equipment should include: Internet and email, copy and fax machines, postage meter and telephone .
Physical and Emotional Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The inability to cope with a stressful work environment does not constitute a protected disability.
While performing the duties of this job, the employee is frequently required to sit. The employee is regularly required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms; climb or balance; stoop, kneel, and talk or hear. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus.
Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually very quiet.
An Equal Opportunity Employer
North America Administrators consider applicants on the basis of qualifications and without regard to race, color, religion, sex, national origin, age, marital or veteran status, sexual orientation, disability or any other legally protected status.
Job Type: Full-time
Job Location:
Nashville, TN
Required education:
High school or equivalent
Required experience:
entering and retrieving database: 3 years
healthcare insurance terminology: 3 years
inbound and outbound call center: 3 years
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