A-G Administrators
Affinity Customer Service Representative
A-G Administrators, Berwyn, Pennsylvania, United States, 19312
The Affinity Customer Service Representative is responsible for handling claim status requests, policy coverage inquiries, and general company questions specifically for Affinity clients - all with the highest level of courtesy and professionalism. This role also manages escalated issues, serves as a liaison with Underwriting and Claim Support to address unidentified policies, and contributes to special projects as needed. The representative will work closely with Affinity Claim Examiners to ensure timely and effective resolution of client inquiries. A successful candidate will demonstrate the ability to resolve issues independently, provide alternative solutions when appropriate, and prioritize customer satisfaction and client retention.
Essential Duties & Functions
Reasonable accommodations may be made to enable individuals to perform the essential functions.
Responds to Affinity client/customer inquiries/information needs via phone, email and chat Handles "client unknown" due to no policy or no claim form - researches and works with Underwriting to determine if policy needs to be assigned Works closely with Affinity team members to ensure a positive customer service experience for all clients Become more knowledgeable with understanding and interpreting policies Gains understanding of customer service operation and management responsibilities Establish and maintain effective relationships with customers, clients, patients, and providers to ensure an overall positive customer service experience Utilize and manage time effectively to ensure the required service levels for calls and emails are met Assist Document Center and Claim Services to troubleshoot any potential error in the claim submission process Escalate inquiries and complaints when required to the Manager Assist Customer Service with non-Affinity customer inquiries when needed Assist with special projects as needed Job Skills
Excellent communication, both written and verbal Strong listening and problem-solving skills Professional and positive attitude Strong respect for confidentiality and knowledge of HIPAA guidelines Effectively operate computer and phone systems and applications including Microsoft Office suite of products Ability to work as an individual contributor and as part of a team
Job 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.
Required/Preferred Education and Experience
Required Education: Associates Degree or equivalent experience
Required Experience: 3-5 years Customer Support/Service work experience
Preferred Education: Associates Degree or higher in Communications, Business, Insurance or other related fields
Preferred Experience: Medical Billing & Coding experience
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and scanners.
Position Type and Expected Hours of Work
This is a full-time position that may be remote or hybrid, depending on the employee's location. however, calls are answered 8:30 AM to 6:00 PM so an alternative schedule may be required. Schedule will be determined on the need of the business and discussed between Supervisor & employee. Urgent or time sensitive requests may require evening or weekend work.
Travel
Limited travel would be encouraged for trainings or team meetings. This would be discussed ahead of time and agreed upon between both Supervisor and employee.
EEO Statement
A-G is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment that is free of harassment, discrimination, or retaliation based on the following protected classes: age (40 and older), race, color, national origin, ancestry, religion, sex, sexual orientation (including transgender status, gender identity or expression), pregnancy (including childbirth, lactation, and related medical conditions), physical or mental disability, genetic information (including testing and characteristics), veteran status, uniformed servicemember status, or any other status protected by federal, state, or local laws. A-G is dedicated to the fulfillment of this policy in regard to all aspects of employment, including, but not limited to, recruiting, hiring, placement, transfer, training, promotion, rates of pay, other compensation, termination, and all other terms, conditions, and privileges of employment. A-G will conduct a prompt and thorough investigation of all allegations of discrimination, harassment, or retaliation, or any violation of the Equal Employment Opportunity Policy in a confidential manner. A-G will take appropriate corrective action, if and where warranted. A-G prohibits retaliation against team members who provide information about, complain about, or assist in the investigation of any complaint of discrimination or violation of the Equal Employment Opportunity Policy.
Essential Duties & Functions
Reasonable accommodations may be made to enable individuals to perform the essential functions.
Responds to Affinity client/customer inquiries/information needs via phone, email and chat Handles "client unknown" due to no policy or no claim form - researches and works with Underwriting to determine if policy needs to be assigned Works closely with Affinity team members to ensure a positive customer service experience for all clients Become more knowledgeable with understanding and interpreting policies Gains understanding of customer service operation and management responsibilities Establish and maintain effective relationships with customers, clients, patients, and providers to ensure an overall positive customer service experience Utilize and manage time effectively to ensure the required service levels for calls and emails are met Assist Document Center and Claim Services to troubleshoot any potential error in the claim submission process Escalate inquiries and complaints when required to the Manager Assist Customer Service with non-Affinity customer inquiries when needed Assist with special projects as needed Job Skills
Excellent communication, both written and verbal Strong listening and problem-solving skills Professional and positive attitude Strong respect for confidentiality and knowledge of HIPAA guidelines Effectively operate computer and phone systems and applications including Microsoft Office suite of products Ability to work as an individual contributor and as part of a team
Job 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.
Required/Preferred Education and Experience
Required Education: Associates Degree or equivalent experience
Required Experience: 3-5 years Customer Support/Service work experience
Preferred Education: Associates Degree or higher in Communications, Business, Insurance or other related fields
Preferred Experience: Medical Billing & Coding experience
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and scanners.
Position Type and Expected Hours of Work
This is a full-time position that may be remote or hybrid, depending on the employee's location. however, calls are answered 8:30 AM to 6:00 PM so an alternative schedule may be required. Schedule will be determined on the need of the business and discussed between Supervisor & employee. Urgent or time sensitive requests may require evening or weekend work.
Travel
Limited travel would be encouraged for trainings or team meetings. This would be discussed ahead of time and agreed upon between both Supervisor and employee.
EEO Statement
A-G is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment that is free of harassment, discrimination, or retaliation based on the following protected classes: age (40 and older), race, color, national origin, ancestry, religion, sex, sexual orientation (including transgender status, gender identity or expression), pregnancy (including childbirth, lactation, and related medical conditions), physical or mental disability, genetic information (including testing and characteristics), veteran status, uniformed servicemember status, or any other status protected by federal, state, or local laws. A-G is dedicated to the fulfillment of this policy in regard to all aspects of employment, including, but not limited to, recruiting, hiring, placement, transfer, training, promotion, rates of pay, other compensation, termination, and all other terms, conditions, and privileges of employment. A-G will conduct a prompt and thorough investigation of all allegations of discrimination, harassment, or retaliation, or any violation of the Equal Employment Opportunity Policy in a confidential manner. A-G will take appropriate corrective action, if and where warranted. A-G prohibits retaliation against team members who provide information about, complain about, or assist in the investigation of any complaint of discrimination or violation of the Equal Employment Opportunity Policy.