Description
The Customer Service Representative will handle inbound telephone calls from members, preferred providers, and healthcare providers, answering benefit inquiries, referral prior authorization status questions, and eligibility questions. The role also researches claim payment inaccuracies, routes claims for adjustments, maintains interaction records, follows up on issues, and collaborates with other teams to resolve complex member problems. The position requires a high school diploma or equivalent and 1–2 years of insurance industry experience, along with strong communication and service skills.
