Customer Service Representative/Call Center Rep

Job Description: POSITION PURPOSE:


Responds to member and provider inquiries over the phone.

Promotes and maintains a positive company image through direct contact with customers.

Complies with all laws and regulations associated with duties and responsibilities.

Necessary Contacts:

In order to effectively fulfill this position the incumbent must be in contact with:

Special Accounts, Member Service, Provider Service, Benefits Administration, Network Administration, Marketing, Accounting and Legal departments as well as members, providers, groups, brokers, other plans, insurance companies, Social Security Administration and Centers for Medicare and Medicaid Services (CMS).

ACCOUNTABILITIES:

Researches several computerized systems to resolve simple to complex member and provider inquires, outside standard procedure to ensure that accurate research is complete prior to execution.

Analyzes and identifies possible system errors and/or patterns and responds to inquiries regarding adjustments, refunds, edits and/or payment registers to ensure completeness, accuracy and customer satisfaction to members and providers.

Reviews and responds to action requests accurately and promptly to ensure service level agreements and quality assurance are in compliant, consistent, effective and efficient.

Maintains knowledge of required lines of business, changes to applicable company policies/procedures, recent laws and regulations, HCPCS coding, ICD-9 codes, medical terminology and related computer systems to ensure information is current and accurate when providing service to members and providers.

Composes and proofreads letters to customers, group leaders, brokers, insurance companies and other plans describing payment amounts or any other written correspondence to ensure customer satisfaction.

ESSENTIAL FUNCTIONS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions.

* Job duties are performed in a normal and clean office environment with normal noise levels.

* Work is predominately done while standing or sitting.

* Physical effort is required to lift, hold, and carry objects up to 15 pounds, occasionally.

* Job duties entail using multiple body parts in a coordinated manner.

* Manual/Finger dexterity in both hands is needed to operate a keyboard and manipulate small objects.

* Sight, hearing, the ability to distinguish colors, and touching are required sensory abilities.

* The ability to read, write, calculate, visualize, and analyze are required.

About Aerotek:

Aerotek, headquartered in Hanover, Md., is a leading provider of technical, professional and industrial staffing services.  Established in 1983, Aerotek is an operating company of Allegis Group, the largest provider of staffing services in the U.S. Aerotek operates a network of more than 200 non-franchised offices throughout the U.S., Canada and Europe. For more information, visit .