• Customer Service Representative, Casualty

    Brighton Health Plan Solutions, LLC (Westbury, NY)


    About The Role

     

    The Customer Service Representative assists members, physicians, hospitals, and other healthcare providers with member benefits, eligibility, and appeals. The Customer Service Representatives must be able to work in various shifts Monday to Friday between the hours of 9AM – 5PM EST.

     

    This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities and activities may change, or new ones may be assigned at any time with or without notice.

    Primary Responsibilities

    + Handle inbound calls from members, medical providers, and others.

    + Listen to and address customer needs and concerns empathetically.

    + Answer questions about, network participation

    + Ensure first contact resolution when possible.

    + Update customer files and communicate effectively with teams.

    + Transfer misdirected requests and offer solutions to non-routine issues.

    + Contribute to customer satisfaction and business improvement.

    + Collaborate with other team members.

    + Adapt responses to caller understanding.

    + Educate callers and validate their understanding.

    + Support projects and other departments as directed by management.

    Essential Qualifications

    The successful candidate will have experience in a high-volume call center, experience with medical specialties, complaints and appeals and call center responsibilities. Previous experience in a physician’s office, group practice, clinic or hospital-based practices.

     

    + High School diploma with some college or business school education preferred.

    + Basic computer operations knowledge.

    + Intermediate proficiency in Microsoft Office (Word, Excel, Access, PowerPoint, Outlook).

    + Strong time management skills.

    + General knowledge of HIPAA Confidentiality laws.

    + Quick learner with ability to grasp managed care procedures.

    + Detail-oriented and dependable.

    + Effective listening and responding skills.

    + Flexible and adaptable to changes, with conceptual thinking.

    + Strong problem-solving abilities.

    + Excellent attendance and punctuality.

    + Comfortable performing tasks at a computer/telephone station.

    + Effective communication through various channels, including email, chat, and voice.

     

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