Job Description
Job Description
Position – Customer Services/Call Center Representative
Location – 2100 Mack Blvd, Allentown, PA 18103
Duration – 6 months with possible extension
Shift – 8am – 4:30pm EST
Pay range – $20.00/hr. to $22.00/hr.
Job Summary:
- Supports a positive service experience while handling member and provider inquiries via telephone, Customer Service portal, or written correspondence.
Job Requirements:
- Fluency in Spanish (STRONGLY PREFERRED)
- High School Diploma/GED
- 2 years Call center experience
- 2 years Insurance and/or claims administration experience
- Ability to take the initiative to identify and carry out responsibilities to their completion.
- High degree of professional judgement and inter-personal skills at all levels and among all disciplines.
- Banking background and credit background, analytic and customer services skillset will be successful
Job Functions:
- Handles 80 - 100 calls per day per rep
- Performs ancillary customer service functions relative to claims, providers, recoveries, and forms or letter generations. Uses multiple systems and screens to efficiently handle interaction.
- Offers solutions that aid and facilitate a unique customer service experience, including First Call Resolution (FCR).
- Anticipates needs; educates members and providers about related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc.
- Engages caller to gather necessary information to guide through plan of benefits, answer questions regarding care needs, and resolve issues.
- Interacts with customers, vendors, and colleagues professionally to ensure questions are answered accurately and in a timely manner.
- Assists with billing questions, claim adjustments, FSA/HSA account, COBRA payments, etc.
- Handles requests related to appeals and pre-authorizations.
- Meets all quality and adherence standards.
- Participates in team and individual discussions related to process improvement.
- Knowledge of insurance or claims administration.
As a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.
Pride Global offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors.
Company DescriptionPride Global offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts.
Company Description
Pride Global offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts.