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6 days old

Customer Service Representative

Kelly Services
Phoenix, AZ 85067
Kelly Services has an immediate need for a Customer Service Representative for one the world's largest healthcare insurance companies in Phoenix, AZ. This is a direct hire opportunity!



Job Summary:



This is a highly specialized customer service position with an emphasis on excellence, privacy, compliance and versatility within the health insurance industry. The position will identify, research, process, resolve and respond to customer inquiries and correspondence via telephone, written communication and/or in person.



Scope of the position includes accountabilities that support the following programs: 1. Utilization Management, 2. Member Relations and 3. Network Management.






Essential Functions and Responsibilities



Identify, research, process, resolve and respond to customer inquiries and correspondence via telephone, written communication and/or in person.



Answer a diverse and high volume of health insurance related customer calls and correspondence on a daily basis.



Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines.



Explain to customers a variety of information concerning the organizations services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, provider networks, etc.



Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.



Document and record facts in regard to inquiries and correspondence by updating files and system.



Demonstrate and maintain current working knowledge of the required systems, procedures, forms and manuals.






Utilization Management-related accountabilities for staff include:



Review of healthcare service requests for completeness of information



Collection and/or transfer of non-clinical data






Utilization Management-related accountabilities for Provider Assistance staff include:



Review of healthcare service requests for completeness of information



Collection and/or transfer of non-clinical data



Collection of defined clinical data using structured scripts or tools



Activities that do not require interpretation of clinical information or decisions regarding utilization of any clinical criteria for handling of a request for healthcare services or treatment



Travel may be required for employees in regional offices






The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.






Required Work Experience



1 years of experience in claims examination, health insurance, customer service, call center, medical office, or other healthcare-related field






Required Education



High-School Diploma or GED in general field of study






Preferred Work Experience



2 year(s) of experience in claim processing, customer service, call center, health insurance, medical office, or other healthcare-related field






Preferred Education



Associate's Degree in general field of study






Preferred Licenses



A valid Arizona driver license with an acceptable driving record if travel is required (e.g. regional employees)






Required Job Skills



Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones



Type 30 to 35 words per minute with 5% error rate or less



Intermediate PC proficiency



Required Professional Competencies



Maintain confidentiality and privacy



Practice interpersonal and active listening to achieve high customer satisfaction



Compose and dictate a variety of business correspondence



Interpret and translate policies, procedures, programs and guidelines



Capable of investigative and analytical research



Navigate, gather, input and maintain data records in multiple system applications



Follow and accept instruction and direction



Establish and maintain working relationships in a collaborative team environment



Required Leadership Experience and Competencies






Preferred Job Skills



Type >35 words per minute with 5% error rate or less



Intermediate knowledge of insurance claim coding



Intermediate understanding of dental and medical terminology



Intermediate comprehension of anatomy and medical practices







**Why Kelly** **** **?**






At Kelly
Services , we work with the best. Our clients include 95 of the Fortune
100 companies, and more than 70,000 hiring managers rely on Kelly annually to access
the best talent to drive their business forward. If you only make one career connection today, connect
with Kelly.






**AboutKelly Services** ****







As a workforce advocate for over 70 years, we are proud to directly employ nearly 500,000 people
around the world and have a role in connecting thousands more with work through our global network of
talent suppliers and partners. Revenue in 2017 was $5.4 billion. Visit kellyservices.com and connect with us on Facebook, LinkedIn and Twitter .



Kelly Services is an equal opportunity employer including, but not limited to, Minorities, Females,
Individuals with Disabilities, Protected Veterans, Sexual Orientation, Gender Identity and is
committed to employing a diverse workforce. Equal Employment Opportunity
is The Law.
Posted: 2019-07-10 Expires: 2019-08-10

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Customer Service Representative

Kelly Services
Phoenix, AZ 85067

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