Welcome to Montage Health's application process! Job Description: The Customer Service Representative is responsible for answering telephone inquiries and responding to correspondence from employer clients, members and providers regarding eligibility, claims status and benefit determinations. Responsibilities * Intake all customer (provider, member and health plan) calls as they relate to inquiries and grievances. * Explain health insurance benefits, policies and procedures to members and providers, i.e., claims submission, appeal process, medical review, documenting all communication. * Investigate timely filing of provider claims. * Serve as a point of contact and liaison for customers. * Successfully implement dispute resolution. * Provide proactive and event-related education to customers. * Facilitate customer care as appropriate. * Assure accurate and timely response to all customer inquiries. * Log calls and document action plans. * Successfully bring all issues to closure within appropriate timeframe. * Proactively identify areas of improvement and provide feedback. * Perform member and provider satisfaction surveys as appropriate. * Provide support and coverage to interdepartmental staff as needed. * Coordinate customer grievances with appropriate department. * Develop strong partner relationship with customers. * Perform other activities and functions as defined by the Claims Manager. Position Requirements * Minimum A.A. degree or equivalent practical experience in related or similar positions. * At least two years' experience in customer service/call center within the managed care, insurance, healthcare, or related call center environment * Strong comprehension skills * Ability to communicate effectively, including written and verbal communication skills * High level of attention to details in obtaining complete and accurate information * Problem resolution skills * Strong interpersonal and negotiation skills * Ability to key data accurately and rapidly * Basic knowledge of insurance terminology and medical coding, e.g. ICD and CPT * Ability to operate computer equipment and software programs necessary to fulfill position responsibilities * Working knowledge of Microsoft office products including Outlook, Word, and Excel * Ability to interact professionally with co-workers, providers, clients, brokers and management-level staff. * Excellent phone manner and ability to handle multiple phone lines. * Must be able to meet established deadlines Pay rate: $23.00 an hour Equal opportunity employer. Assigned Work Hours: 8:00am - 4:30 pm Position Type: Regular