EmblemHealth
Summary of Position
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 related claims approving and clerical work as assigned.
Perform other duties as assigned or required.
Regular attendance is an essential function of the job.
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. 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, including salvage and/or completion by letter. Typing and PC skills. Ability to adapt to change and address multiple issues simultaneously. Good organizational skills. Must be available for training.
Qualifications Education, Training, Licenses, Certifications A minimum of two (2) years' experience in customer service; one year must be in a call center setting. A college degree is preferred.
Relevant Work Experience, Knowledge, Skills, and Abilities Health insurance experience is a plus. Additional Information
Requisition ID: 1000002630_114 Hiring Range: $24.67 per hour
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. 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, including salvage and/or completion by letter. Typing and PC skills. Ability to adapt to change and address multiple issues simultaneously. Good organizational skills. Must be available for training.
Qualifications Education, Training, Licenses, Certifications A minimum of two (2) years' experience in customer service; one year must be in a call center setting. A college degree is preferred.
Relevant Work Experience, Knowledge, Skills, and Abilities Health insurance experience is a plus. Additional Information
Requisition ID: 1000002630_114 Hiring Range: $24.67 per hour