Client Services Representative
: Job Details :

Description

MISSION

Our mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors.

VALUES

HealthOne is guided by a cultural framework that embodies our values and drives our decisions.

Our PURPOSE is to care for people by connecting them to resources that help protect them in health related situations. To fulfill our purpose, we align our PRIORITIES to ensure each decision we make is ethical, empathetic, economical, and efficient. We care for PEOPLE by being welcoming, authentic, truthful, consistent and humble. We are continuously looking for ways to improve our PROCESS and how we get things done.

HealthOne seeks individuals with integrity and heart to embody our values. Whether you're starting your career or looking to develop additional skills to reach your full potential, HealthOne provides the means to help you achieve your goals.

JOB PURPOSE

The Client Services Representative addresses inquiries, questions and concerns in all areas including enrollment, eligibility, claims, benefit interpretation, and referrals/authorizations for medical care. The position is responsible for receiving, responding to, and directing member, broker and provider phone calls and other communications and provides available information upon request and escalates issues as appropriate.

Requirements

ESSENTIAL JOB DUTIES

* Receives client calls or inquiries, which include potential/current/previous members, brokers and providers, and routes appropriately

* Provides timely and accurate information to clients

* Processes client requests according to established department policies and procedures

* Completes research and investigative activities to address client inquiries

* Works closely with other departments to gather information

* Provides timely feedback to clients through outbound calling, email, mail or fax

* Provides timely feedback to the company regarding service failures, systemic issues or client concerns

* Assists in the completion of special projects

* Assists in the documentation, evaluation and revision of department policies and procedures

* Meets or exceeds service level agreements in call center metrics

* Attends and participates in meetings and trainings as required

* Regular and predictable attendance

* Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice

* Maintains regular and predictable attendance

* Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice

* Works to encourage and promote Company culture throughout the organization

* Other duties as may be assigned

QUALIFICATIONS

* Requires a high school diploma or its equivalent

* Ability to learn quickly and be self-motivated

* Customer service experience preferred

* Confidentiality and time management skills

* Bilingual preferred

* Knowledge of healthcare billing, claims and insurance a bonus

PHYSICAL REQUIREMENTS

Prolonged periods of sitting at a desk and working on a computer. Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day responsibilities. Must be able to drive a vehicle and daytime/overnight travel as required.

BENEFITS

401K (4% Match, Immediate Vesting)

Accident insurance

Competitive salary

Critical Illness Insurance

Dental Insurance

Employee Assistance Program

Flexible Spending Account

Health & Wellness Program

Health Savings Account

Life & AD&D Insurance

Long Term Disability Medical Insurance

Medical Insurance

Paid Time Off

Pet Insurance

Short Term Disability

Vision Insurance

PRE-EMPLOYMENT SCREENING

Drug Screen and Background Check Required

HEALTHONE IS AN EQUAL OPPORTUNITY EMPLOYER

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, disability, sex, age, ethnic or national origin, marital status, sexual orientation, gender identity or presentation, pregnancy, genetics, veteran status or any other status protected by state or federal law.