Health care + 1 more
Description
Qualifications
Must have a diploma or bachelor’s degree certificate
Excellent English written and oral communication skills
Portuguese written and oral skill is a must
Exceptional organizational and time-management focus
Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity.
1+ years of customer service experience analyzing and solving customer problems required; call center experience a plus
Ability to perform in a high volume, fast paced call center environment
Proven ability to work independently as well as a productive member of a team
Intermediate proficiency in Microsoft office suite; high level capacity to multitask independently and on a computer
Knowledge of medical terminology a plus
Responsibilities
Handle calls and e-mails and respond to simple and complex inquiries regarding eligibility, cards status, envoy registration/navigation, policy benefits, issue certificates of insurance, claims status and other related information and provide solutions for customers and clients.
Receives requests by mail, telephone, or in person regarding insurance claims/policies. Responds to inquiries from policy holders, clients, brokers and/or others.
Performs research to respond to inquiries and interprets policy provisions to determine most effective response.
Mails or routes claim forms and supporting documentation to various units for final processing.
Excellent interpersonal skills, ability to understand and interpret policy provisions. Independently responds to inquiries, grievances, complaints, or appeals ranging from routine to moderate complexity.
May seek assistance with complex customer services issues.
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