Premier Administrative Solutions
Medical Insurance Call Center Representative [Full Time]
Premier Administrative Solutions, Clearwater, Florida, United States, 34623
Medical Insurance Call Center Representative [Full Time]
Clearwater, FL
Summary Premier Administrative Solutions (PAS) is a Third-Party Administrator that provides a wide range of administrative services to insurance companies, sharing organizations, insurance marketing organizations, and employers. One such service is Member and Provider Services, where inbound and outbound calls and correspondence from members or covered individuals and their providers are managed. This role is critical to PAS’ success, effectively and efficiently handling calls and correspondence while meeting strict service level agreements for accuracy, resolution, and satisfaction.
Benefits
VERY competitive pay/compensation package
Monthly metric-based bonuses!
NO selling, NO weekends
Monday - Friday, Day Shift
Paid Training, Health, Dental, Vision, and Life Insurance as well as Paid Time Off and Paid Holidays
Health Coverage – two flexible medical plans
Dental & Vision – comprehensive coverage by Sun Life; Vision is company paid
Health Savings Account (HSA) – pre‑tax contributions
Flexible Spending Accounts (FSA) – Medical and Dependent Care options
Life & Disability Insurance – company‑paid with optional additional coverage
Generous Paid Time Off (PTO) and additional paid holidays
Employee Assistance Program (EAP) – wellness support
401(k) Retirement Plan – company match after meeting eligibility requirements
Frequent and ongoing employee appreciation and celebration throughout the company
Essential Duties and Responsibilities
Participate in team meetings and discussions to improve service results
Promote a culture of exceptional service and transparency with team supervisors and management
Meet department productivity standards (calls per day/week, queue time, service levels such as 45‑second answer, average speed to answer, longest hold time, and abandon rate)
Maintain a pleasant and helpful demeanor on the telephone, ensuring members’ and providers’ needs are met
Accurately identify caller issues and provide clear, understandable responses (minimum 3 calls per week audited for accuracy)
Document all calls per company standards (caller, reason for the call, sufficient information for team members)
Escalate calls appropriately via transfer to a senior representative or supervisor
Explain steps and expected timeframes for research‑intensive calls, and maintain responsibility for status communication
Adhere to HIPAA Privacy and Data and System Security policies at all times
Essential Duties Continued
Ensure messages left for the team or outbound calls are followed up within 1 working day
Respond to correspondence received by the team within 1 working day; urgent e‑mail within 4 hours
Follow attendance policies (planned time off, sickness, start time, break times)
Identify and share ideas for improving documentation or approach with the supervisor
Primary Performance Expectations Team Telephone Service Levels
80% of calls reach a live representative within 30 seconds
Average speed to answer less than 30 seconds
Abandon rate less than 5%
Individual Production Level
Handle a minimum of 275 transactions per week (calls, outbound calls where the target is reached, written responses)
Quality Level
Minimum of 10 calls per week audited with an overall team score of at least 95%
Experience and/or Education
High school graduate or equivalent
Knowledge of medical terminology, billing, claims, and the health insurance industry is strongly preferred but not required
At least one year experience in an inbound customer service center focused on health insurance or provider billing
Strong organizational, interpersonal, and motivational skills
Excellent listening, written, and verbal communication skills
Ability to perform multiple tasks simultaneously (listening, navigation, documentation)
Environmental Factors / Physical Demands Work is performed in an office environment. Employees are required to maintain active communication with customers, access and input data into computer systems, and use a keyboard and monitor for extended periods. Repetitive motion such as typing and data entry, and occasional light lifting up to 30 pounds may occur.
HIPAA and Data Privacy Obligations
Absolute confidentiality – PHI must not be disclosed to unauthorized individuals under any circumstances
Secure environment – a private, locked workspace must be maintained to prevent exposure of PHI to family members, visitors, or others
Company‑approved technology only – all work must be performed on secure, company‑issued devices using encrypted connections (VPN required)
Other Responsibilities
Adhere to company policies and procedures
Maintain strict confidentiality of client, company, and personnel information
Demonstrate a strong commitment to the mission and values of the organization
Adhere to company attendance standards
Perform other duties as assigned
At-Will Employment (Florida) Employment in Florida is at‑will; either party may terminate the employment relationship at any time, with or without cause or notice. Nothing in this letter creates a contract for continued employment.
Drug‑Free Workplace Premier Family of Companies and its affiliates are committed to a safe, healthy, and productive work environment. A pre‑employment drug screen is required for conditional offers, with the possibility of random and post‑incident testing.
Job ID: PA123
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Summary Premier Administrative Solutions (PAS) is a Third-Party Administrator that provides a wide range of administrative services to insurance companies, sharing organizations, insurance marketing organizations, and employers. One such service is Member and Provider Services, where inbound and outbound calls and correspondence from members or covered individuals and their providers are managed. This role is critical to PAS’ success, effectively and efficiently handling calls and correspondence while meeting strict service level agreements for accuracy, resolution, and satisfaction.
Benefits
VERY competitive pay/compensation package
Monthly metric-based bonuses!
NO selling, NO weekends
Monday - Friday, Day Shift
Paid Training, Health, Dental, Vision, and Life Insurance as well as Paid Time Off and Paid Holidays
Health Coverage – two flexible medical plans
Dental & Vision – comprehensive coverage by Sun Life; Vision is company paid
Health Savings Account (HSA) – pre‑tax contributions
Flexible Spending Accounts (FSA) – Medical and Dependent Care options
Life & Disability Insurance – company‑paid with optional additional coverage
Generous Paid Time Off (PTO) and additional paid holidays
Employee Assistance Program (EAP) – wellness support
401(k) Retirement Plan – company match after meeting eligibility requirements
Frequent and ongoing employee appreciation and celebration throughout the company
Essential Duties and Responsibilities
Participate in team meetings and discussions to improve service results
Promote a culture of exceptional service and transparency with team supervisors and management
Meet department productivity standards (calls per day/week, queue time, service levels such as 45‑second answer, average speed to answer, longest hold time, and abandon rate)
Maintain a pleasant and helpful demeanor on the telephone, ensuring members’ and providers’ needs are met
Accurately identify caller issues and provide clear, understandable responses (minimum 3 calls per week audited for accuracy)
Document all calls per company standards (caller, reason for the call, sufficient information for team members)
Escalate calls appropriately via transfer to a senior representative or supervisor
Explain steps and expected timeframes for research‑intensive calls, and maintain responsibility for status communication
Adhere to HIPAA Privacy and Data and System Security policies at all times
Essential Duties Continued
Ensure messages left for the team or outbound calls are followed up within 1 working day
Respond to correspondence received by the team within 1 working day; urgent e‑mail within 4 hours
Follow attendance policies (planned time off, sickness, start time, break times)
Identify and share ideas for improving documentation or approach with the supervisor
Primary Performance Expectations Team Telephone Service Levels
80% of calls reach a live representative within 30 seconds
Average speed to answer less than 30 seconds
Abandon rate less than 5%
Individual Production Level
Handle a minimum of 275 transactions per week (calls, outbound calls where the target is reached, written responses)
Quality Level
Minimum of 10 calls per week audited with an overall team score of at least 95%
Experience and/or Education
High school graduate or equivalent
Knowledge of medical terminology, billing, claims, and the health insurance industry is strongly preferred but not required
At least one year experience in an inbound customer service center focused on health insurance or provider billing
Strong organizational, interpersonal, and motivational skills
Excellent listening, written, and verbal communication skills
Ability to perform multiple tasks simultaneously (listening, navigation, documentation)
Environmental Factors / Physical Demands Work is performed in an office environment. Employees are required to maintain active communication with customers, access and input data into computer systems, and use a keyboard and monitor for extended periods. Repetitive motion such as typing and data entry, and occasional light lifting up to 30 pounds may occur.
HIPAA and Data Privacy Obligations
Absolute confidentiality – PHI must not be disclosed to unauthorized individuals under any circumstances
Secure environment – a private, locked workspace must be maintained to prevent exposure of PHI to family members, visitors, or others
Company‑approved technology only – all work must be performed on secure, company‑issued devices using encrypted connections (VPN required)
Other Responsibilities
Adhere to company policies and procedures
Maintain strict confidentiality of client, company, and personnel information
Demonstrate a strong commitment to the mission and values of the organization
Adhere to company attendance standards
Perform other duties as assigned
At-Will Employment (Florida) Employment in Florida is at‑will; either party may terminate the employment relationship at any time, with or without cause or notice. Nothing in this letter creates a contract for continued employment.
Drug‑Free Workplace Premier Family of Companies and its affiliates are committed to a safe, healthy, and productive work environment. A pre‑employment drug screen is required for conditional offers, with the possibility of random and post‑incident testing.
Job ID: PA123
#J-18808-Ljbffr