Healthcare Claims CSR II

Hiring Immediately Job title :Bilingual customer service Position Purpose:Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner * Reference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits and authorization status matters* Provide assistance to members and/or providers regarding website registration and navigation* Educate members and/or providers on health plan initiatives Provide first call resolution working with appropriate internal/external resources, and ensure closure of all inquiries* Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application * Process written customer correspondence and provide the appropriate level of follow-up in a timely manner * Research and identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment* Identify trends related to member and/or provider inquiries that may lead to policy or process improvements that support excellent customer service and impact quality and performance standards* Work with other departments on cross functional tasks and projects* Maintain performance and quality standards based on established call center metrics including turn-around times
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email accommodation@aerotek. com for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.