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Customer-Service-Representative---Dean-Health-Plan

SSM Health


Location:
Madison, WI 53786
Date:
10/15/2020
2020-10-152020-11-14
Categories:
  • Customer Service
SSM Health
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Job Details

Divison:

This is for our location in Madison, Wisconsin.

Looking for a minimum of 1 to 2 years of customer service experience. Ideal candidate is comfortable with high volume in bound calls, comfortable sitting for long periods of time, able to multi-task and is tech savvy.

Hours of operation are Monday - Friday 8:30 am to 5:00 pm.

PRIMARY RESPONSIBILITIES

+ Educates and informs members of available benefits under the health plan and coordinates the exchange of information among members, providers, and internal departments involved.

+ Instructs members how to receive maximum benefit reimbursement, including the advantages of utilizing their primary care physician and network providers.

+ Determines various policy provisions, guidelines, providers, and provider requirements and procedures; medical review procedures; and the procedures of company departments that apply to the need of the member.

+ Accesses and researches various information databases to provide answers and make appropriate decisions about the callers situation.

+ Documents each phone call in accordance with departments standards, monitors the types of inquires received, and reports trends and concerns to management.

+ Stays abreast of related regulatory, compliance, and departmental updates to meet departmental metric requirements.

+ Performs other duties as assigned.

EDUCATION

+ High school diploma or equivalent

EXPERIENCE

+ No experience required

PHYSICAL REQUIREMENTS

+ Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.

+ Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.

+ Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.

+ Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.

+ Frequent keyboard use/data entry.

+ Occasional bending, stooping, kneeling, squatting, twisting and gripping.

+ Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.

+ Rare climbing.

SSM Health is committed to equal employment opportunity based on race, color, religion, national origin, gender, sexual orientation, gender identity, pregnancy, age, physical or mental disability, veteran status, and all other statuses protected by law.
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