<p>The Customer Service Representative is responsible for answering phone calls in a prompt and courteous manner to achieve contractual obligations. Responsible for answering Member's and Provider's questions with a quick and accurate response. They are also responsible for timely completion of all correspondence and reporting functions associated with the Customer Service Department.</p> <p>Required:</p> <ul> <li>High School Graduate: prefer 1-2 years college with interest or concentration in health field. </li><li>Strong ability to relate with a variety of people in a non-judgmental manner. </li><li>Strong organizational, verbal and written communication skills. </li><li>Possess some knowledge of the health care system. </li><li>Personal Computer (PC) and Keyboard skills. </li><li>Proper usage of the English Language. </li><li>Courteous manner/even temperament. </li><li>Excellent communication skills. </li></ul> <p>Desired:</p> <ul> <li>Previous call center experience. </li><li>Medical Terminology. </li><li>CPT and ICD-9/ICD-10 Coding. </li><li>Familiar with medical and hospital claims. </li><li>Familiar with Prescription Coding (NDC). </li><li>Familiar with Coordination of Benefits Ruling. </li></ul> <p>Responsibilities:</p> <ul> <li>Takes an average of 40-60 calls daily </li><li>Has established adequate proficiency in using the application necessary to perform the functions of a Customer Service Representative. </li><li>Maintains monthly monitoring score of 90% accuracy or above on the 17 Points of Excellence. </li><li>Demonstrates a complete understanding of departmental policies and procedures. </li><li>Able to perform assigned tasks with minimal supervision. </li><li>Meets requirements on annual performance evaluation. </li><li>Consistently displays a positive attitude and acceptable attendance. </li><li>Increasing improvement in performance and job knowledge. </li><li>Documents calls according to departmental guidelines. </li></ul>