Customer Service Representative

Role Overview

MagnaCare is looking for dedicated Customer Service Representatives to work fully remotely. The role involves assisting members, physicians, hospitals, and healthcare providers by addressing inquiries related to member benefits, eligibility, claims issues, claim reconsiderations, and appeals.

Key Responsibilities

• Welcome customers with a polite and professional demeanor following established procedures.
• Pay close attention to customers' needs and concerns, showing empathy and providing suitable solutions.
• Ensure the customer understands the solution and provide further education when necessary.
• Accurately document all interactions and update customer records appropriately.
• Collaborate efficiently with team members to ensure timely and high-quality responses to customer requests.
• Redirect misdirected inquiries to the correct departments or personnel effectively.
• Suggest ideas to resolve issues aiming to improve customer service and workflow efficiency.
• Provide solutions to non-standard and complex issues that may require clarifications.
• Support additional call center functions and projects as assigned by management.
• Balance call demands while meeting quality standards, average handling time, and productivity goals.
• Use appropriate language and provide information tailored to the caller’s level of understanding regarding MagnaCare’s processes and plan details.
• Actively educate callers and confirm their comprehension before ending the call.

Qualifications and Skills

• High school diploma required; some college or business school education is advantageous.
• Basic computer proficiency along with intermediate skills in Microsoft Office and email communication.
• Familiarity with CPT codes and ICD-9 is beneficial; ability to learn promptly is essential.
• Strong customer service orientation with courteous communication.
• Dependable with excellent attention to detail.
• Effective listening and response abilities.
• Adaptable and able to think conceptually to handle changes swiftly.
• Robust problem-solving skills.
• Consistent punctuality, attendance, and reliable work history are mandatory.