Examine health claims for the Medicare Supplement line of business. Interact with internal and external customers, to answer inquiries, resolves issues, and handle customer concerns while maintaining a professional image through superb telephone etiquette and excellent customer service.
Responsibilities and duties
- Approve or reject health claims according to Everence policy and certificate guidelines.
- Complete data entry into Group+ to adjudicate claims charges.
- Perform appropriate correspondence via letter or telephone for claim completion.
- Answer inquiries regarding eligibility and confirmation of benefits for coverage of proposed services for Medicare Supplement plans
- Answer inquiries regarding status of claims payment for Medicare Supplement plans.
- Document all customer service contacts.
- Perform other duties and assignments as requested by manager.
- Excellent verbal and written interpersonal and communication skills including high level of listening skills.
- Customer oriented with the ability to adapt and respond to different types of customers with sensitivity.
- Demonstrates positive leadership skills and takes initiative.
- Ability to make quick and appropriate decisions despite interruptions.
- Flexibility with changing work patterns and/or varying work loads.
- Excel at problem solving.
- Attention to detail with the ability to multi-task, prioritize while manage time effectively.
- Medical and/or insurance background desirable.
- Proficient in use of Microsoft Office software.
- Ability to develop and maintain a strong sense of teamwork.
- High School graduate.
- Must be able to maintain call center hours.
Schedule: This is a full-time position.
Location: Everence Corporate office - Goshen, Indiana